STAFF PERFORMANCE APPRAISAL FORM (Teaching).docx

Staff appraisal form

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STAFF PERFORMANCE APPRAISAL FORM ( TEACHING STAFF)
Introduction
Staff Performance Assessment is part of the Performance Management System of Soroti
University. It is used as a management tool for establishing the extent to which set targets
within overall mandates of the University are achieved. Through staff performance
evaluation, performance gaps and development needs of an individual employee are
identified. The evaluation process offers an opportunity to the staff and Supervisors to
dialogue and as well as obtain a feedback on performance. It is our call as a University to
encourage participatory approach to the Evaluation process and consistence in the filling
this form.
DD MM YY DD MM YY
PERIOD OF ASSESSMENT: FROM ……… …… …… TO ……… …… ……


SECTION A
1.0 PARTICULARS OF STAFF (To be filled be the Appraisee)

Name of the Appraisee:

……………………………………………………………………………………………………………………….
DD MM YY

Date of Birth ……………. ………….. ………..……

School……………………………………………………………Department……………………………………………

Job Title………………………………… ………………………………. ……………………… Salary Scale …………

DD MM YY

Date of Present Appointment ……………. ………….. ………..……


Terms of Service (Tick)


Email Address …………………………………………… Phone ……………………………………………
Permanent Probation Contract Temporary

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Name of the Appraiser/ Supervisor …………………………………………………………………………
Job Title/Rank …………………………………………Salary
Scale………………………………………….
SECTION B
This part is to be completed by the appraise. He/she is required to state personal data and
complete the self-assessment with an option attitude.

a) Records of employment
S/N Post (Begin with current and
write in descending order)
Scale From (Month
& Year)
To ( Month &
Year)
1
2
3
4
5

b) Academic/Professional/Technical Qualifications and year (s) when obtained
S/N Qualifications Institutions Year
1
2
3
4

c) List any other studies being undertake
S/N Course Institution Expected year of
Completion
1
2

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3

d) Teaching and Publications
S/N Title Publication/Journal Date
1
2
3
4
5

e) Meetings/Workshops/Conferences
List the Professional meetings or workshops or conferences (Relevant to your job) you have
attended this academic year.
S/N Meeting/Workshop/Conference Topic Date
1
2
3
4
5

f) Public Lecturer Paper Presented
State in order of importance the public lecturers and papers presented since you joined
Soroti University
S/N Public Lecture Topic Date
1
2

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3
4
5

g) Research Activities and Community Service/Engagement
State any research activities undertaken/conducted/Supervised/research
grant/Community service or on-going.
S/N Research activities Topic
1
2
3
4
Research grant applied for and awarded Amount Granted
1
2
3
4
Community Service since you joined Soroti
University
Activity & Date
1
2
3
4

SECTION D: ASSESSMENT OF THE LEVEL OF ACHIEVEMENT OF AGREED OUTPUTS
AND TARGETS

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This section should be filled by both the Appraiser and the Appraisee. At the beginning of
each assessment period, the Appraiser and Appraisee will agree on the key outputs for the
assessment period.
The means by which performance shall be measured (Perfo rmance Indicators) and the
minimum level of performance (performance targets) for each output shall be agreed upon. If
in the course of the assessment period, other activities are assigned to the Appraisee, the
outputs related to the new activities should be agreed upon and included immediately or at
least before the end of the assessment period. It is recommended that the maximum number
of outputs for each assessment period should not exceed 10.
At the end of the assessment period, an appraisal meeting should be conducted by the
Appraiser. The Appraisee completes part B (1), before the appraisal meeting, by indicating
the key outputs, performance indicators and targets agreed upon in the performance plan at
the beginning of the assessment period. The Appraiser should complete part B (2), after the
appraisal meeting. The assessment should reflect the jointly agreed position.

The assessment of the Individual outputs shall be reflected as a performance level under
section B (2), this will be supported by relevant comments on performance under the same
section. The performance levels shall be described as Outstanding (5), Very Good (4), Good
(3), Fair (2) and Unsatisfactory (1). In order to quantify the assessment the performance levels
shall be awarded scores

B1
Agreed Key Outputs, performance Indicators and
Targets
B2
Agreed Assessment of
performance between the
Appraiser and the Appraisee
Key Outputs
(Deliverables
from the Job
Descriptions and
other
assignments ,
usually written
in past tense)
Performance
Indicators
(How were the
achieved )
Performance
Indicators
(An agreed
Minimum Level
of performance )
Performance
level
Comments on
performance
1.
2.
3.
4.

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5.

Definition of the Performance Levels
Outstanding (5): The Appraisee has exceeded the agreed targets and has consistently
produced results of excellent quality and demonstrated a high level of
productivity and timeliness. The Appraisee is a model of excellence in both the
results achieved and the means by which they are achieved.
Very good (4): The Appraisee achieved all the agreed outputs in line with the agreed targets.
The Appraisee consistently meets expectations for the outputs achieved and the
means by which they are achieved.
Good (3): The Appraisee achieved most, but not all the agreed outputs in line with the
agreed targets, and there is no supporting rationale for not meeting the other
commitments.
Fair (2): The Appraisee has achieved minimal outputs in line with the agreed targets and
without a supporting rationale for inability to meet the commitments.
Unsatisfactory (1): The Appraisee has not achieved most of the agreed targets and without
supporting rationale for not achieving them.


Assessment of Performance of Key Agreed Outputs
Overall assessment of performance of agreed outputs should be derived by adding the scores
at each performance level and the total divided by the total number of outputs. The average
of the scores obtained shall be the overall assessment of agreed outputs.
.

Performance Level

Tick the relevant box



SECTION E: ASSESSMENT OF CORE COMPETENCIES AND WORK RELATED
BEHAVIOUR
This section should be filled by the Appraiser after joint discussions between the Appraiser
and Appraisee. The assessment will help establish any areas where some training or
development is necessary. The Appraisee should be rated only in areas, which are relevant
to his/her job. The maximum points per competence are 5, where 5 is for Outstanding, 4 –
Very Good, 3 – Good, 2 – Fair, 1 – Unsatisfactory, N/A – Not Applicable. The Appraiser should
give work related examples under comments, to justify their rating.

PERFORMANCE AND CONDUCT

EVALUATION
OUTCOME
COMMENTS
Outstanding
(5)
Very good
(4)
Good
(3)
Fair
(2)
Unsatisfactory
(1)

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Performance Level
Attained (please Tick)
1. Proficiency at work
Has clear understanding of the job, what
it involves and practices.
5 4 3 2 1 N/
A

2. Responsibility
Seeks and accepts responsibility at all
times in the delivery of his/her work

3. Planning, and organizing
Prioritizes own work, develops and
implements plans;

4. Team work
Works cooperatively and collaboratively
with team members;

5. Dedication
Exercises commitment and keenness at
work

6. Expressive Maturity
Is responsive, sensitive and passionate
to his/her feelings and feelings of others


7. Relationship with Colleagues
Wins and retains the higher regard of all
and relates with colleagues at work place
cordially, is very collaborative with
colleagues and consults constantly

8. Integrity
Is honest and of high moral character,
has self-respect and respects others. Is
Courteous and Mindful to all staff and
the public.

9. Quality
Distinguished for accurate and thorough
work, Maintains a high standard of work
and approaches quality as a way of life


10. Customer care
Responds well and attends to clients, is
Outstanding and effective in dealing with
them. Reflects a good image for the
University while in the public domain.

11. Time Management
Always in time for work and
accomplishes tasks in time required and
maximizes the use of time to achieve set
targets.

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12. Ability to express Himself/
herself
Speaks respectfully, clearly and fluently;
Actively listens.

13. Initiative/Innovation
Is open to new ideas; curious about and
actively explores new possibilities;
identifies how to create more value for
customers; takes action on innovative
ideas and champions innovation.

14. Loyalty
Complies with lawful instructions of
Supervisor and is able to provide ongoing
support to Supervisors.

15. Relations with Non- University
Community
Is courteous, respectful and supportive
to the non-members of the community

Any other relevant Competence
NB: The appraise and the appraise tick the applicabe scores but using different ink.
Scores: The total Appraisee’s score…………………………………………………………
The total Appraiser’s score…………………………………………………………
The total agreed score……………………………………………………………….
SECTION F: PERFORMANCE IMPROVEMENT ACTION PLAN
The Action Plan shall be jointly agreed during the performance appraisal meeting, taking into
consideration the Appraisee’s required job competences and the identified performance gaps.
The action plan to improve performance may include; Training, Coaching, mentoring,
attachment, job rotation, counseling and or provision of other facilities and resources.
Where the plan (s) involves formal training of the Appraisee, the record should be forwarded
to the Human Resource Unit for an on ward submission to the University Training and
professional training Committee.


Performance Gaps specific to
the period under assessment
Agreed action plan to
address gap identified
Time Frame

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SECTION G: COMMENTS, AND SIGNATURES
This section is to be completed by the Appraisee, Appraiser and the Accounting Officer. It is
a confirmation that the performance review and evaluation meeting took place and that there
was agreement or if there was disagreement, it was resolved by all the parties. It is also
confirmation that the action plan to improve performance was discussed and agreed upon.
The Appraisee / Appraiser / other officers should use this section to comment about the job,
career and any other relevant information
COMMENTS OF THE STAFF/APPRAISEE
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
…………………………………………..………………………………………………………………….…………
DD MM YY

Signature…………………………………….
COMMENTS OF THE SUPERVISOR/APPRAISER
………………………………………………………………………………………………………………………
…………………………………… …………………………………………………………………………………
……………………………………………………………………………………………...…………………………
DD MM YY

Signature…………………………………………


COMMENTS OF THE UNIVERSITY SECRETARY/ACCOUNTING OFFICER
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
……………………………………………………………………………………......…………………………….…
Name ……………………………………………………….………………………....……………….………….......
DD MM YY

Date


Signature …………………………………………….