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DAVIE COUNTY SCHOOLS Custodian Performance Appraisal Instrument

Name of Employee___________________________________Position______________ School or Department___________________________Date of Evaluation____________ Encircle the number which best represents your evaluation of the employee’s work habits and abilities:

1. EXCEEDS 2. MEETS 3. NEEDS 4. UNSATISFACTORY 5. NO OPPORTUNITY EXPECTATIONS EXPECTATIONS IMPROVEMENT TO OBSERVE

WORK QUALITY/QUANTITY Fulfills work assignments/requirements Uses sound judgment Performs job accurately Demonstrates ability to work without supervision as needed Shows pride in work performed

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

WORK ATTITUDES Shows initiative Is dependable Accepts direction without resentment Cooperates with others

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

WORK HABITS Takes advantage of opportunities for self-improvement Conforms to work hours Observes established lunch and/or break periods Limits personal business and visits to non-work hours Uses work time wisely and appropriately

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

PERSONAL CHARACTERISTICS Shows logic and reasoning Maintains emotional stability and poise Demonstrates honesty and integrity Communicates effectively with others Adapts to changes in routine Dresses appropriately for work assignments Shows consideration for others

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

SUPERVISORY SKILLS (IF APPLICABLE) Gets along with subordinates and superiors Creates favorable work climate Makes fair and reasonable work assignments Assumes responsibility for making decisions up to limits of authority given Is supportive of the goals and policies of the system

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

RECOMMENDATIONS ______ I recommend continued employment. _______ I recommend placing the above named employee on probation for a period of ________________ beginning__________________, 20__. I have so advised him/her in writing and have/will develop strategies and resources to help this employee improve. _______ I recommend termination. I have specified the reason in a separate letter to the employee. A copy has been forwarded to the Human Resource Department and a copy has been placed in the personnel files maintained by the evaluator. EMPLOYEE COMMENTS (OPTIONAL)____________________________________________________ ______________________________________________________________________________________

EVALUATOR COMMENTS (OPTIONAL)__________________________________________________ ______________________________________________________________________________________ ___________________________________ Employee’s Signature Date ___________________________________ Evaluator’s Signature Date Evaluator’s Position

Signature indicates that the written evaluation has been seen and discussed.