ANNUAL PERFORMANCE APPRAISAL FORM
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Name
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Department
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Emp Code:
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Present Designation/Grade
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Qualification
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Date of Joining
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Month of Last Increment
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Experience at Agarwal Nursing Home:
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Past Experience:
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Total Experience:
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Sr. No.
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Factors
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Score
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App-raiser
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Reviewing Officer
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Comments
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01
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Technical/Functional Knowledge
(As defined in
the role profile)/
Efforts/Application
of knowledge
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10
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02
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Planning & Execution
Effectiveness in
anticipating needs, Resourcing, Execution of plans, Optimum utilization of
resources, Delivery, Time Management ,Cost consciousness/ effectiveness,
Waste control
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10
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03
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Customer Satisfaction
Responsive to
needs of the customers(Internal/External)
Track record in meeting commitments to customers in terms of Quality
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10
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04
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Problem Solving & Contribution in decision making
Proactive,
Ability to identify root cause of problem(s), Effectiveness in problem solving
independently/under guidance , Contribution in decision making
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10
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05
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Team Work & Team Building
Collaboration
& co-operation, Constructive confrontation, Empathize with team
members, Trust & respect, Ownership of team decisions, Transparency,
Training & Development
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10
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06
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Interpersonal Relations
Ability to
communicate effectively, Ability to promote open and constructive working
relationship, Coaching & counseling skills
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10
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07
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Responsibility/Reliability
Willingness to
assume & Discharge functions, Reliability & dependability
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10
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08
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Analytical Ability
Does he/she think
logically? Is he/she analytical? Can grasp complex issues quickly? Does
he/she get to the core of an issue?
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10
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09
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Initiative & Innovativeness
Self Starter,
Generation and implementation of
value adding ideas,
Innovative
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10
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10
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SAFETY/DISCIPINE
Self disciplined,
Ensuring discipline at work place, Adherence Safety norms
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10
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Total
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100
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Percentage
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Category
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Rating
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Range
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Kindly
tick the Appropriate Rating
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A
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Outstanding
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> 90%
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B
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Very Good
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>80% -
90%
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C
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Good
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>65% -
80%
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D
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Satisfactory
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>50% -
65%
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E
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Below Average
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< 50%
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DATE:
HEAD OF
DEPARTMENT
Comments & Recommendations by reviewer/hr
Comments:
DATE: MANAGER-HR
FOR APPROVAL TO MD:
_______________________________________________________________________________________________________________
DATE: MANAGING DIRECTOR
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