UNIVERSITY SHRA
EMPLOYEE
ANNUAL PERFORMANCE APPRAISAL
PROGRAM
SAMPLE
BUILDING &
ENVIRONMENT
SERVICES
TECHNICIAN
(ADVANCED)
ANNUAL APPRAISAL FORM
.
SHRA Performance Appraisal Policy
Sample Job Description, Performance Plan, and Annual Appraisal
BUILDING & ENVIRONMENTAL SERVICES TECHNICIAN (ADVANCED)
Division of Vice Chancellor for Finance & Administration, Facilities Services / Building & Environmental Services
Housekeeping Services is comprised of a staff of more than 400 employees who provide cleaning service and floor
care to over 40,000 campus customers in the maintenance and operation of the University’s 8 million plus sq.ft.
across approximately 250 teaching, research, medical, administrative, residential, athletic, and library buildings.
The position provides daily routine and detail cleaning of campus building interior and exterior areas. This position
also serves as an on‐site lead worker for one or more teams of Housekeepers (5‐15 employees), including duties
for: coordinating daily routine and detail cleaning; monitoring workplace safety; coordinating work assignments;
preparation and inventory of supplies and distribution trays; and conducting on‐the‐job training.
1
40% CLEANING & MAINTENANCE
• Performs daily routine and detail cleaning of campus building interior and exterior areas
assigned by supervisor including but not limited to offices, lounges, restrooms, student housing,
classrooms, laboratories, entrances, exits, and stairways.
• Performs general duties including vacuuming, sweeping, mopping, dusting, trash removal and
related duties using department‐determined cleaning methods.
• Organize and maintain custodial closet.
• Stock and label housekeeping products and supplies, including but not limited to cleaning
solutions, toilet tissue, and paper towels to ensure ample supply to carry out duties.
• Inspects and cleans equipment and ensures equipment is operational daily.
• Reports any needed repairs to Zone Manager (ZM).
2
40% LEAD WORKER
• Coordinates work and cleaning process of the housekeepers for specific teams assigned to the
area. Leads assigned personnel to accomplish non‐routine cleaning and special projects.
• Serves as a liaison between crew and the ZM, inspects assigned areas and provides input to ZM
on the quality and quantity of daily work produced by the team.
• Instructs and assists housekeepers as needed in cleaning procedure and techniques by applying
department‐determined cleaning methods. Assists ZM with training employees, with
verification and certification of employee cleaning practices and responsibilities.
• Work with Housekeeping management and other campus staff to resolve customer needs and
may serve as a liaison to building contacts for emergencies and service calls.
• Responsible for simple recordkeeping including daily entries in the filter/solution change log;
maintaining/evaluating equipment/supply logs; and completing inventory of distribution trays.
• Assists ZM with ordering, distribution, and storage of chemicals, tools, equipment, and supplies.
3
10% SAFETY
• Provides safety training to assigned staff as required.
• Mixes and uses cleaning chemicals, supplies and operating equipment in accordance with
manufacturer’s label.
• Wears proper personal protective equipment (PPE) as required (gloves, goggles, safety shoes).
• Ensures wet floor signs are out and visible when performing floor maintenance duties.
• Reports injuries to ZM immediately and may assist ZM in addressing workplace accidents.
• Custody of University keys/card access and other university equipment and supplies; may issue,
receive, and secure keys for assigned areas.
4
10% ADDITIONAL DUTIES
• May include individual or group project work such as clean baseboards; strip and refinish floors
as needed; short‐staffing duties; emergency clean‐up; department committees; etc.
• May transport employees and equipment to and from worksites as necessary.
Rev. 07‐19‐2016
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 2 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
PART 1: PERFORMANCE PLAN (see instructions on page 2)
• Review the Institutional Goals with the employee.
• Define the Individual Goals for the employee
(no less than 3, no more than 5).
• Provide Talent Development Goals, as needed.
• Indicate below the Weight of each goal toward the
Final Overall Rating. Each goal must be at least
5%.
• The total weight of the Institutional Goals must equal 50%.
• The total weight of the Individual Goals must equal 50%.
Type of Plan: Initial Performance Plan:
X
Revised Plan during Performance Cycle:
PART 2: INSTITUTIONAL GOALS
(see instructions on page 2)
Review the institutional goals with each employee. Discuss these goals in relationship to the duties on the employee’s position
description. Provide additional clarification of specific expectations as needed. Weight each goal.
EXPERTISE ENTER WEIGHT: 10%
a. Precision: Produces work that is accurate, thorough, and demonstrates sufficient analysis and decision‐making to
meet the requirements of the employee’s position and profession.
b. Resourcing: Makes efficient and appropriate use of materials and documents work appropriately.
c. Innovation: Looks for ways to improve efficiency or quality.
d. Development: Maintains technical skills and relevant professional credentials.
ACCOUNTABILITY ENTER WEIGHT: 10%
a. Productivity: Completes required volume of work by established deadlines and stays productive throughout workday.
b. Autonomy: Generally completes work with few reminders and/or infrequent oversight.
c. Prioritizing: Takes sufficient/appropriate measures to plan and organize work, prioritize tasks, and set realistic goals.
d. Coordination: Seeks needed information to complete work and timely communicates status with relevant parties.
CUSTOMER‐ORIENTED ENTER WEIGHT: 10%
a. Clarity: Listens to determine the most effective way to address customer needs and concerns.
b. Awareness: Shows a solid understanding of customer needs, seeks out customer input to better understand needs,
and develops ideas to meet those needs.
c. Attentiveness: Follows through on commitments, despite time pressures or obstacles, and maintains relevant
communication with customers until job is completed.
d. Diplomacy: Maintains a professional and respectful tone and exhibits diplomacy when dealing with frustrated
individuals or during sensitive or confrontational situations.
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 3 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
TEAM‐ORIENTED ENTER WEIGHT: 10%
a. Collegiality: Communicates and engages directly, clearly, and tactfully with colleagues.
b. Collaboration: Provides feedback and healthy dialogue on performance and operational issues, as requested, willingly
adapts to change, and adheres to decided actions.
c. Contribution: Makes decisions with others in mind, and willingly performs additional duties when team members are
absent, during times of increased workload, or as otherwise required by management to meet business needs.
d. Attendance: Absences are infrequent and do not place an undue burden on supervisor or colleagues.
COMPLIANCE & INTEGRITY ENTER WEIGHT: 10%
a. Policy: Complies with personnel and equal opportunity policies, including prohibitions on harassment, discrimination,
and workplace violence, and all other policies, including appropriate use of university resources.
b. Safety: Complies with all safety requirements for the position, including successful completion of training and proper
use of personal protective equipment.
c. Ethics: Chooses ethical actions, even under pressure, avoids situations considered inappropriate or that present a
conflict of interest, holds self and others accountable for ethical decisions.
d. Respect: Appreciates individual and cultural differences and treats all people with dignity and respect.
SUPERVISION (for supervisors only) ENTER WEIGHT:
n/a
a. Oversight: Provides adequate stewardship of assigned resources, including budget, space, equipment, and staffing.
b. Goal‐Setting: Provides clear objectives that foster work unit development and align with University values and goals.
c. Managing Talent: Provides candid, timely, and constructive feedback on performance and behavior, hires individuals
with the qualities and skillsets for success, and contributes to meeting University’s EO and affirmative action goals.
d. Leading: Serves as role model and engenders trust, commitment, and civility.
PART 3: INDIVIDUAL GOALS (see instructions on page 2)
Set 3 to 5 individual goals for each employee based on key business needs and strategic goals. Weight each goal.
GOAL #1 ‐‐ Title: QUALITY ASSURANCE ENTER WEIGHT: 20%
Description: Score 80‐90% on each monthly Team Checklist to ensure consistency in our cleaning practices so that
our buildings are clean and safe for our customers. Any issues noted on Team Checklist must be
resolved immediately and will be rechecked by the Zone Manager within five business days.
GOAL #2 ‐‐ Title: ATTENDANCE ENTER WEIGHT: 20%
Description: Adhere to the Facilities Services Attendance Policy and maintain an overall attendance record of
85‐90% for the performance cycle to ensure service delivery and fair distribution of work among
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 4 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
team members. Attendance averages will be reviewed quarterly with each employee. Absences due
to Adverse Weather or Family/Medical Leave will not be included in total absences.
GOAL #3 ‐‐ Title: SAFETY TRAINING ENTER WEIGHT: 10%
Description: Attend 80‐89% of all scheduled safety trainings and receive a passing score on all exit quizzes to
ensure your safety knowledge is being maintained so that you are working safely. Missed trainings
made up within 30 days of the scheduled date will count toward meeting the expectation.
GOAL #4 ‐‐ Title: n/a ENTER WEIGHT:
Description:
GOAL #5 ‐‐ Title: n/a ENTER WEIGHT:
Description:
PART 4: TALENT DEVELOPMENT PLAN
(see instructions on page 2)
At the beginning of the performance cycle, the supervisor should discuss development opportunities with the employee and list below
any development activities established for the current cycle. Include resources that will be provided to the employee and indicate
deadlines as needed. Progress under the talent development plan should be discussed periodically with the employee.
Simone has expressed interest in becoming a Zone Manager, so I would like her to complete at least three supervisory
and/or HR Policy training programs offered through the Human Resources Office during this performance cycle.
PART 5: SIGNATURES FOR PERFORMANCE PLAN (see instructions on page 2)
2
nd
– Level
Supervisor:
Date:
Supervisor:
Date:
Date of Review Session with Employee:
Employee Acknowledgement: I acknowledge that I have received this performance plan and that if
I choose, I may write additional comments to include with this document.
(Check this box if you are
attaching comments.)
Employee:
Date:
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 5 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
PART 6: OFF‐CYCLE REVIEWS (see instructions on page 2)
Document all off‐cycle reviews completed during the performance cycle.
Date of Review
Interim
Probationary
Other
Supervisor Initials
Employee Initials
06‐30‐16
x
NEN
SRC
Comments: Simone has completed all of her training modules and understand the operational aspects of the job
well. She has quickly gotten to know her customer contacts and is establishing good working
relationships with them. Attendance: 95%
Date of Review
Interim
Probationary
Other
Supervisor Initials
Employee Initials
10‐15‐16
X
X
NEN
SRC
Comments: Simone continues to meet expectations. I’m getting excellent comments from her building contacts.
There have been a few bumps in the road in motivating her co‐workers. Simone sometimes loses
patience with employees who do not understand as quickly as she does. In one instance, she met
with the employee again to address the concern and that interaction went much better. Simone
completed the giving effective feedback training program this quarter. Attendance: 89%
Date of Review
Interim
Probationary
Other
Supervisor Initials
Employee Initials
01‐25‐16
X
NEN
SRC
Comments: Simone is generally meeting expectations. Her customer contacts are still strong. She trained two
new
employees this quarter and did well in teaching them the techniques and protocols. General
interactions with her co‐workers have been better this quarter, but Simone needs to adapt to their
styles more to help them listen to her better. Checklists and Safety training goals are currently at the
exceeding expectations level. In the past several months, Simone has called out or been late, but has
not consistently called in before her shift start time to let me know. It is very important to our work
coordination that I am aware of this before the work day begins, so there will need to be
improvement in this area. Attendance: 81%
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 6 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
PART 7: ANNUAL PERFORMANCE APPRAISAL (see instructions on page 2)
• Rate each Individual and Institutional Goal.
1 = Not Meeting Expectations
2 = Meeting Expectations
3 = Exceeding Expectations
• Multiply the Weight by the Rating to get the Score for each
goal. Use two decimal places. (Example: 10% x 2 = 0.20)
• Add all of the Scores together to assign a Final Overall Rating.
1.00 to 1.69 = Not Meeting Expectations
1.70 to 2.69 = Meeting Expectations
2.70 to 3.00 = Exceeding Expectations
• Provide comments and signatures on the next page.
#
INSTITUTIONAL GOALS (see descriptions in performance plan) Weight
x
Rating
=
Score
1 Expertise 10%
x
3
=
0.30
2 Accountability 10%
x
2
=
0.20
3 Customer‐Oriented 10%
x
3
=
0.30
4 Team‐Oriented 10%
x
2
=
0.20
5 Compliance & Integrity 10%
x
2
=
0.20
6 Supervision (if applicable)
‐
x
‐
=
‐
#
INDIVIDUAL GOALS (title only from performance plan) Weight
x
Rating
=
Score
1 Quality Assurance 20%
x
3
=
0.60
2 Attendance 20%
x
2
=
0.40
3 Safety Training 10%
x
3
=
0.30
4 n/a
‐
x
‐
=
‐
5 n/a
‐
x
‐
=
‐
FINAL OVERALL RATING (mark the appropriate rating based on total score)
TOTAL SCORE
=
2.5
Has the employee received a disciplinary action during this performance cycle and/or received any
rating of 1 (Not Meeting Expectations) on this appraisal? If YES, then the final overall rating cannot
equal Exceeding Expectations, regardless of the total score.
YES
NO
X
NOT MEETING
EXPECTATIONS
MEETING
EXPECTATIONS
X
EXCEEDING
EXPECTATIONS
OR: Employee was not evaluated due to … Insufficient Time
On Extended Leave
University SHRA Annual Performance Appraisal Form
SAMPLE PERFORMANCE APPRAISAL ‐ Rev. 10‐24‐2016
Page 7 of 7
ANNUAL PERFORMANCE APPRAISAL CYCLE (Dates From/To):
04‐01‐2016
to
03‐31‐2017
Dept. Name: Environmental Services Employee Name: Simone Cree
Dept. #: 712004 Employee ID: 1234‐56789 Position #: 9999555
Supervisor Name: Ned Nash Employee Classification: Building & Env. Services Technician
Supervisor Title: Zone Manager Competency Level: Advanced
PART 8: SUPERVISOR COMMENTS ON EMPLOYEE’S PERFORMANCE
Simone has adjusted well to the Team Leader role in our Zone. She very quickly developed strong and positive
relationships with her building contacts, and I have received many positive comments from them about her
responsiveness, courteousness and attention to detail. She quickly got up‐to‐speed on our team cleaning model, works
efficiently, and has done well in spot‐training technique with the staff. When employees are absent, she has been very
helpful to me in quickly determining ways to accomplish and assign the work.
Although Simone met our attendance goal expectations, she has been slow to contact me if she is going to be out or late,
often calling out after the start of her work shift, which doesn't allow as much time to plan for her absence and attend to
her duties. This is particularly important in the crew leader position.
Simone is still adjusting to being in a leadership role in the Zone and balancing her relationships with other employees.
She is always helpful to her team, but is still learning how to adjust her communication styles to coach other staff. She has
had some difficult interactions with several co‐workers that resulted from some misunderstandings and misperceptions. I
encourage her to find more opportunities to have conversations with co‐workers that are not always about work
assignments and apply some of her strong customer service skills to her coworker relationships.
Simone is doing a good job learning the University and Facilities policies and procedures, and I encourage her to continue
to build her knowledge base so that she can apply it more readily across the Zone.
Goal 1: 92.0%
Goal 2: 87.5%
Goal 3: 92.0%
PART 9: SIGNATURES FOR ANNUAL PERFORMANCE APPRAISAL
2
nd
– Level
Supervisor:
Date:
Supervisor:
Date:
Date of Annual Performance Appraisal Review Session with Employee:
Employee Acknowledgement: I understand my signature below indicates: that I have received this annual
performance appraisal, that my signature does not necessarily imply my agreement with the ratings given or
the comments included, and that if I choose, I may write a response to include with this appraisal document.
(Check here
if
you are
attaching
comments.)
Employee:
Date:
PART 10: APPEAL RIGHTS
For information on applicable appeal rights, please refer to the University System SHRA Employee Grievance Policy.
