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Sample Performance Appraisal Record Instructions: This form is intended to be used as documentation of an employee's performance. It is a tool for supervisors to take notes about their feedback to employees on their key performance objectives. The specific behavior should reference the appropriate key objective taken from the performance appraisal form. Supervisor and employee should sign and date the form.
The signing of this form does not mean you agree with the observation, only that the supervisor and employee have discussed it. Employees may be given a copy of this record. |
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| Key Objective | Specific Behavior and Date | |
| Follows safety guidelines and maintains safe working conditions | Positive: Mary was observed taking time to put on her safety equipment and encourage others to do the same. When the other crew members commented that it was not necessary, Mary talked to them about the value of using the belt. | |
| Negative: Mary was observed not using safety equipment. We discussed today the pros and cons of using the safety equipment required for her job. Although Mary expressed some frustration with taking the time to put the equipment on, Mary committed to following expectations. I will continue to observe proper usage of safety. | ||
| Date: XX/XX/XX | ||
| Supervisor: XXXXXX | ||
| Employee: XXXXXX | ||