Muhammad Junaid Khan

Employee Evaluation Form At an Affinity Living Group Managed Community Employee Information Employee Name: Start Date: Position: Start Date of Current Position: Manager: Department: Today’s Date: Date of Last Review: Review of Previous Period Rating Scale 1 2 Outstanding – 3 points Highly Competent – 2 points 3 4 Competent – 1 point Needs improvement – 0 points Results – Projects and Goals Goal # Goal Description 1 2 3 4 Rating Comments 4 1 2 4 Core Competencies Core Competencies Rating Comments Mission & Values: Supports mission and values in daily actions and decisions, and in short-term and long-term planning; communicates mission to others. 4 September 2011 Page 1 Employee Evaluation Form At an Affinity Living Group Managed Community Core Competencies Census Performance: Census average of _____ last 12 months vs. _____ budget = _____ variance Less than 5% above budget – outstanding 5% above budget – highly competent At budget – competent Below budget – needs improvement Quality Service Delivery: Employee is dedicated to assuring excellence in quality of service delivery (e.g. state surveys, resident surveys, programming, etc.) and is able to communicate those standards to all parties involved. Continuously strives to meet or exceed customer expectations and to improve the quality of services provided. Helps maintain a clean and safe environment. Integrity: Employee is widely trusted and seen as a direct, truthful individual; is honest and able to present the truth in a straightforward and helpful manner; keeps confidences; admits and takes responsibility for mistakes; does not misrepresent him/herself or the Company for personal gain. Fulfills commitments in a timely and responsive manner. Employee Respect/Teamwork: Employee establishes good working relationships with co-workers and fosters cooperative spirit between departments and shifts; creates strong morale in his/her team; shares successes; allows team members to be responsible for their work. Keeps team members well informed. Exceptional Customer Service: Employee is dedicated to identifying and meeting the expectations and requirements of both internal and external customers; gets first hand information and uses it to improve services; acts with the customer in mind; demonstrates ability to handle difficult or emotional situations in a helpful, courteous manner. September 2011 Rating Comments 4 4 4 4 4 Page 2 Employee Evaluation Form At an Affinity Living Group Managed Community Core Competencies Caring: Employee is committed to valuing differences and respecting the well-being and dignity of each person. Demonstrates understanding and respect for the feelings and viewpoints of others. Takes action at point of service to immediately meet the customer’s needs. Respects the privacy and confidentiality of all individuals. Job Knowledge: Demonstrates competency in job skills and knowledge. Learns and applies new skills within expected time period. Displays a good understanding of how job relates to others. Dependability: Employee reports promptly for all scheduled shifts. Willing to assist others upon request. Problem Solving: Thinks creatively, asks questions to get beneath the surface, solves problems in context with the big picture, and understands how to apply his or her skills to reach the Company goals. Initiative: Volunteers to help others. Seeks increased responsibilities. Demonstrates an effort to improve performance. Does not hesitate to ask for assistance when needed. Safety: Demonstrates ability and willingness to work safely. Ensures work areas are kept safe and free of hazardous conditions. Has knowledge of, and complies with safety rules. Reports unsafe conditions, potential hazards and/or workplace injuries, accidents or illnesses to management immediately. Professionalism: Clean, professional dress and appearance; positive ethical conduct. Overall average rating: Rating Comments 4 4 4 4 4 4 4 4 Planning for the Next Review Period Your performance goals will contribute to obtaining first-class performance in 3 ways; goals which support the overall community’s goals, your manager’s goals and your own contribution to your team. Each goal should be expressed as an end result answering “What needs to be achieved?” with indicators of success answering “How will I know when it’s achieved?” this gives you a ‘mental image’ of the end result helping you to determine actual, realistic deliverables. Goals should be developed using the SMART concept - SMART: Specific, Measurable, Agreed, Realistic, Time Related September 2011 Page 3 Employee Evaluation Form At an Affinity Living Group Managed Community Next Period – Performance Goals and Projects Goal # 1 2 3 4 Goal Description Target Date Your personal development goals should focus on helping you to improve your performance against your performance goals by demonstrating and growing your strengths in the core competencies required for your position. Personal development goals should also help you grow for the future. Work with your manager to identify 2 or 3 areas for development based on your goals and your future career interests. Use the SMART criteria for writing personal development goals and be sure to describe how you will demonstrate progress/what will be different. Next Period – Personal Development Goals Skill # Personal Development Goals and Steps Required to Achieve It Target Date 1 2 3 4 Summary Overall Performance Rating: 4 Manager Comments: Manager Signature: Date: Employee Comments: Employee Signature: September 2011 Date: Page 4 Employee Evaluation Form At an Affinity Living Group Managed Community I understand that by signing this evaluation, I am not indicating agreement with the ratings, but am acknowledging that my supervisor has reviewed and discussed this document with me. I further understand that this document in no way modifies my at-will status of employment. September 2011 Page 5