Appraisal Form (HoD)

 

PUBLIC SERVICE OF ZIMBABWE

 

PERSONNEL PERFORMANCE WORK PLAN & APPRAISAL

 

 

PERIOD OF ASSESSMENT: FROM:______________ TO:____________________

 

 

 

Distribution    –        1 copy to appraisee

–        1 copy to the appraisee’s personal file

 

Section 1        PERSONAL DETAILS AND SERVICE PARTICULARS

 

Name:_______________________________

 

E.C.  No_____________________________ National I.D. No______________________

 

Qualifications: _____________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Experience: ________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Date of Appointment into Service:___________________________________________

 

Current Post___________     Date of Appointment to the Post_________________

 

Ministry____________________________________________________________________

 

Department____________________________ Station ____________________________

 

Appraiser’s Position: ________________________________________________________

Reviewer’s Position: ________________________________________________________

 

NOTE:

 

See Guidelines for Completion

 

SECTION 2:  PERFORMANCE PLAN & ASSESSMENT 

  1. OUTPUT PERFORMANCE (Total Weightage: 60%)

 

Dept. KRA Ref.   KRA Description.  
Dept. Goal Ref.   Goal Description.  
Dept. Obj Ref   Objective Description  
Outcome Ref   Outcome Description  
Output Ref   Output Description.   Weight Agreed Target Actual Perf. Allowable

Variance

Actual Variance Rating Weighted Score
               
Quantity Description.     Standard                
Quality

Description.

    Standard                
Timelines

Description.

    Standard                
Cost

Description.

    Standard                
Output Ref   Output Description.                
Quantity Description.     Standard                
Quality

Description.

    Standard                
Timelines

Description.

    Standard                
Cost

Description.

    Standard                
Output Ref   Output Description.                
Quantity Description.     Standard                
Quality

Description.

    Standard                
Timelines

Description.

    Standard                
Cost

Description.

    Standard                
Total

 

 

Note: Create additional tables where necessary

 

 

 

 

 

 

 

  1. OUTCOME PERFORMANCE (Total Weightage 30%)

 

Dept. KRA Ref.   KRA Description  
Dept. Goal Ref   Goal Description  
Obj Ref   Objective Description  
    Outcome Description Outcome Indicator Weight Agreed Target Actual Performance Allowable

Variance

Actual Variance Rating Weighted Score
Outcome Ref         .        
Outcome Ref                  
Outcome Ref                  
Dept. KRA Ref.   KRA Description  
Dept. Goal Ref   Goal Description  
Obj Ref   Objective Description  
    Outcome Description Outcome Indicator Weight Agreed Target Actual Performance Allowable

Variance

Actual Variance Rating Weighted Score
Outcome Ref         .        
Outcome Ref                  
Outcome Ref                  

 

 

 

Note: Create additional tables where necessary

_____________________________________________________________________________________________________________________

 

 

  1. BUDGET PERFORMANCE (10%)

 

    Budget Expenditure Performance

 

Approved Budget Allowable

Variance

Actual Expenditure Actual Variance Rating

 

 

 

         

 

 

 

 

Note: For purpose of assessment of budget utilization ‘Total Approved Budget’ excludes salaries

———————————————————————————————————————————————————————————–

SECTION 3:     TRAINING AND DEVELOPMENT NEEDS

Competency Assessment:

 

REQUIRED COMPETENCIES FOR THE JOB EXISTING COMPETENCIES (related to the job) COMPETENCY GAPS (specific skills required) INTERVENTION STRATEGIES (e.g. training, counseling, transfer etc.) ACTION RECOMMENDED (e.g. specific course) ACTION TAKEN
1st Quarter  
     

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date received by Ministry’s Human Resources department: __________________Name ____________________________Signature_______________

2nd Quarter

 

     

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date received by Ministry’s Human Resources department :__________________Name ___________________ _________Signature_______________

 

REQUIRED COMPETENCIES FOR THE JOB EXISTING COMPETENCIES (related to the job) COMPETENCY GAPS (specific skills required) INTERVENTION STRATEGIES (e.g. training, counseling, transfer etc.) ACTION RECOMMENDED (e.g. specific course) ACTION TAKEN
 

3rd Quarter

     

 

 

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date received by Ministry’s Human Resources department: __________________Name ____________________________ Signature_______________

 

 

 

 

REQUIRED COMPETENCIES FOR THE JOB EXISTING COMPETENCIES (related to the job) COMPETENCY GAPS (specific skills required) INTERVENTION STRATEGIES (e.g. training, counseling, transfer etc.) ACTION RECOMMENDED (e.g. specific course)  
 

4th  Quarter

     

 

 

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date received by Ministry’s Human Resources department: __________________Name ____________________________ Signature_______________

 

 

 

AGREEMENT OF WORK PLAN
Signature of Appraisee: Date:
Signature of Appraiser: Date:
Signature of Reviewer: Date:

____________________

 

 

 

 

 

 

SECTION 4:     PERFORMANCE PROGRESS REVIEWS

 

4A. Comments on progress should be performance related.

 

Interim Progress Review Final Performance Review & Assessment
1st Quarter Review 2nd  Quarter Review 3rd Quarter Review 4th Quarter Final Review/Assessment
Strengths Areas for Improvement Strengths Areas for Improvement Strengths Areas for Improvement Strengths Areas for Improvement
               
Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments Appraiser’s Comments
 

 

 

   
Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments Appraisee’s Comments
 

 

 

 

   
Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (where applicable) Reviewer ‘s Comments (required) Reviewer ‘s Comments (required)
 

 

 

 

   
1st Quarter Review 2nd Quarter Review 3rd  Quarter Review 4th Quarter Review
Signature of Appraisee: Signature of Appraisee: Signature of Appraisee: Signature of Appraisee:
Date: Date: Date: Date:
Signature of Appraiser: Signature of Appraiser: Signature of Appraiser: Signature of Appraiser:
Date: Date: Date: Date:
Signature of Reviewer (where necessary) Signature of Reviewer (where necessary) Signature of Reviewer (where necessary) Signature of Reviewer: (Where necessary)
Date: Date: Date: Date:

 

 

 

 

4B. Adjustments to work plan, where necessary.

 

Period:  From…………………….  To……………………..

Work plan adjustments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appraisee`s comments to justify the  adjustments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature…………………………Date………………………………….

                       Appraisee

Appraiser’s comments to acknowledge adjustments to the work plan:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature………………………………Date…………………………………

                         Appraiser

 

 

Reviewer’s comments (where necessary):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature ……………………………………….Date……………………………………

                     Reviewer

 

 

SECTION 5:             FINAL PERFORMANCE ASSESSMENT & RATING

                                                           

5A: Rating on Output Performance                                           Rating on Outcome Performance

 

KEY RESULT AREA

REF.

OUTPUT REF. WEIGHTED SCORE   KEY RESULT AREA

REF.

OUTCOME

REF.

WEIGHTED SCORE
             
         
         
             
         
         
             
         
         
             
         
         
             
         
         
TOTAL       TOTAL  

 

 

 

 

 Rating on Budget Utilisation  

 

                            

 

 

(Actual Final Rating is the aggregate of the rating on output performance, outcome performance and budget utilization).

 

 

 

Actual Final Rating:

 

 

 

 

 

 

5B.   PERSONAL DIMENSIONS

 

Based on the assessment of achievements/results, establish any areas where some training or development may be necessary.  Although feedback on this page would not be used to determine the appraisee’s ratings – the feedback is very important to help the subordinate know which areas need improvement.

 

Pinpointed supporting remarks are to be provided.  For example, what specific BEHAVIOUR which is job related the appraiser witnessed to support his/her point. Fill in both strengths and or areas for improvements.

       

     STANDARD  DIMENSIONS

COMMENTS ON DIMENSIONS
Strengths Areas for improvement
PLANNING AND ORGANIZING

Sets goals and priorities, plans solutions, plans ahead and utilises resources effectively. Ability to meet deadlines, and to monitor tasks and activities.

 

 

 

LEADERSHIP MANAGEMENT

Motivates, co-ordinates, guides and develops subordinates` respect through actions and attitudes. Effectively manages and implements changes.

 

 

 

JUDGEMENT

Considers pros and cons before making decisions; anticipates short and long term impacts; weighs risks involved.

 

 

COMMUNICATION

Effective verbal skills; presents ideas and information concisely and persuasively; keeps others informed; courteous to the public; inspires confidence in subordinates and superiors.

 

 

CONTROL

Takes action to monitor or regulate processes, tasks or activities. Keeps track of delegated assignments. Delegates tasks to achieve results using subordinates effectively.

 

 

 

COOPERATION

Willingness to work with others in achieving individual and team objectives.

 

 

INITIATIVE

Actively attempts to influence events to achieve goals. Self starter, generates improved solutions to problems.

RELIABILITY

Can be counted on to achieve set objectives without supervision or coercion.

 

 

QUALITY OF WORK

Achieves high quality work that meets or exceeds requirements of the job.

 

 

QUANTITY OF WORK OUTPUT

Meets or exceeds the standard amount of work expected on the job.

 

 

OTHER

(Please specify)

 

 

 

 

5C:   OVERALL COMMENTS ON THE APPRAISEE’S POTENTIAL WITH REGARDS TO CAREER

      PROGRESSION: (for example, the member’s potential for promotion)

 

_______________________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

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        Final Appraisal
Signature of Appraisee: Date:
Signature of Appraiser: Date:
Signature of Reviewer: Date: