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Appendix E: Project or Assignment Checklist Appendix F: Sample Performance Evaluation
Clerkship Assignment Checklist Performance Evaluation

Employee Name: Supervisor Name:
¨ Date Assigned:
Employee Title: Date of Evaluation:
________________________________________________________________________
GENERAL INSTRUCTIONS
¨ Assignment Title: Performance management is a continuously shared communication process focusing on the individual development of each employee. It
is a cycle with expectations communicated at the beginning of the year and a formal evaluation of the employee’s performance at the end
________________________________________________________________________
of the year. However, ongoing communication and coaching are the key components of the process.
Carefully evaluate the employee’s work performance in relation to the key job responsibilities and performance standards of the job.
¨ Final Due Date/Deadline: Assign points for each rating within the scale and write that number in the corresponding rating area. Points will be totaled and averaged
for an overall performance score. Indicate N/A if not applicable and do not count in the overall score.
________________________________________________________________________
There shall be at least a formal year-end performance evaluation meeting. The employee’s performance of key job responsibilities will be
evaluated based on the rating categories listed below.
¨ Interim Deadlines (Is there an estimate for how much time should be spent on this project? At what point
should check-ins occur? (After initial research, after x number of hours, after first draft): The first pages of this form are intended to be kept for use by the supervisor and/or employee.
________________________________________________________________________ PERFORMANCE RATINGS
(3) Exceeds Expectations: Performance consistently exceeds documented expectations and measurements. The employee
consistently does work going far beyond what is expected in terms such as quantity, quality, timeliness, cost, and customer satisfaction.
¨ Format Requested (memo/draft pleading; hard copy/email): Performance that “Exceeds Expectations” is due to the effort and skills of the employee. Performance is consistently characterized
by exceptionally high quality work that requires little or no improvements or corrections. An employee at this level repeatedly makes
________________________________________________________________________ exceptional or unique contributions to the organization that are above the requirements of his/her duties and responsibilities. An
employee performing at this level should be readily recognized by their organization as an outstanding contributor to the organization’s
mission.
¨ If there is a sample available of the expectation of the final draft, has it been sent to the clerk? (2) Meets Expectations: Performance consistently meets and occasionally exceeds the defined job expectations and measurements.
The employee performs according to expectations. The employee does the job at the level expected for this position and consistently
¨ Yes meets what is expected in terms such as quantity, quality, timeliness, cost, and customer satisfaction. The performance is due to
the employee’s own effort and skills. An employee performing at this level is dependable and makes valuable contributions to the
¨ No
organization. His/her judgments are sound, and he/she demonstrates knowledge and mastery of duties and responsibilities. Most
employees should meet expectations in a functional, performing work unit.
¨ File Name and Location:
________________________________________________________________________ (1) Does Not Meet Expectations: Performance does not meet job expectations and measurements and supervisory attempts to
encourage performance improvement are unsuccessful. The employee is performing the job at an unacceptable level in terms such
as quantity, quality, timeliness, cost, and customer satisfaction, and performance improvement counseling by the manager/supervisor
has not resulted in adequate employee performance improvement. Managers/supervisors are required to continue addressing
¨ Any existing research or preliminary information the clerk should review before starting this performance issues with an employee with this rating level, documenting management efforts to encourage acceptable performance, and
project? Any suggested primary/secondary research tools? documenting subsequent results on a Performance Improvement Plan. Performance counseling sessions should be guided by next-level
management and/or HR, and may result in disciplinary consequences for the employee who fails to demonstrate improvement.
________________________________________________________________________ PERFORMANCE FACTORS
________________________________________________________________________ Please supply supportive details or comments for each factor.
1. Work Quality Rating ( )
The accuracy, thoroughness, and acceptability of work performed.
¨ How will this information/document be used?

________________________________________________________________________
________________________________________________________________________
2. Productivity Rating Rating ( )
The extent to which the employee efficiently produces volume of work in a specified period of time.
¨ Who is the intended audience?

________________________________________________________________________

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