NAGURU TEENAGE INFORMATION AND HEALTH CENTER

P.O. Box 27572, Kampala-Uganda

Tel: 0393-216-467

STAFF PERFOMANCE APPRAISAL

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Name of Employee / Appraisee:	Name of Supervisor / Appraiser:
	1st Level Aupervisor 2nd Level Aupervisor
Title:	Appraisal period
Department	Appraisal date

Basis for Assesssment and development

Staff performance appraisal is a management tool for establishing the extent to which the set targets/objectives within overall goals of an organization are achieved. The appraisal process offers an opportunity to the appraisee and appraiser to dialogue and obtain a feedback on performance.

The evaluation system enables the performance of all employees to be analyzed and documented. It is a participatory process in which the employee is given an opportunity to evaluate themselves and rate their performance on a pre-determined scale. The employee shall then discuss their scores with their respective supervisors and or line managers, who shall also score the employee against the same yardstick. The employee shall finally be expected to identify skills gaps in which they require professional skills training, as the supervisor/Line manager shall also be expected to give an evaluation of the competencies of the staff with regard to their ability to effectively attain their professional targets.

Deadline for submission:

This means that all sections must be completed before this date; by the Appraisee, Appraiser, Appraiser’s appraiser and Program Director, working together to ensure this deadline is met.

I, while recognizing that provision of quality youth friendly services to young people starts with me; pledge to live and uphold all the NTIHC values of youth friendly services, confidentiality, gender equality, right to choice, right to evidence based information, and Integrity in all that I do. I will seek to understand and consciously uphold all Policies, Guidelines and Procedures in place, in the drive to promoting access to quality ASRHS and information by young people. I recognize that the cornerstone of our success is offering the best service to our clients and stakeholders as a team, and with purpose and passion, and as such will maintain an attitude of service at all times.

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SECTION A: TO BE COMPLETED BY THE APPRAISEE

Marital status	Telephone contact
Number of biological children and their ages	Date of first appointment
Present residence location	Designation on 1st appointment

A 1: Appraisee's Current Details:

A 2: Terms of Employment (Please tick appropriately)

probation	Contract	Temporary	Others (specify)

A 3: New/ additional Academic & Professional Qualifications acquired and short term training courses attended during appraisal period

*	Award (Degree, Diploma, Certificate)	Institution	Study period ( From - To )

SECTION B

TO BE COMPLETED BY THE APPRAISEE AND APPRAISER

Section B.1: Tasks (Results) Assessment:

This section is a summary of the Employee’s Assessment of their performance. The Employee shall be expected to identify the core responsibilities as per their job descriptions/pre-determined agreed objectives and targets, and to score themselves against a scale of 1 to 10, with 1 being the lowest and 10 being the highest score, in reference to the above performance level categories. The Appraiser will then appraise the employee performance and indicate the scores in the column for the appraiser. The Appraiser and Appraise will then have a dialogue meeting to discuss the performance, the performance and arrive at an agreed score to be filled in the column for agreed score.

Each score must be justified and supported with explanations and details of the actual activities undertaken.

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*	CORE RESPONSIBILITIES/PERFORMANCE OBJECTIVES	ACTIVITIES	APPRAISEE SCORE (10)	JUSTIFICATION (Give details of performance rating as against core duties /objectives/targets in quantifiable sums. E.g number of Deliverables seen.	APPRAISER'S SCORE	APPRAISER'S COMMENT	AGREED SCORE

SUMMARY OF RATINGS / SCORES FOR B.1

APPRAISEE SECTION	APPRAISER SECTION	APPRAISEE AND APPRAISER DIALOGUE SECTION
Total Score by Appraisee : 0.0	Total Score by Appraiser :	Total Agreed Score :
Signature :	Signature :	Signature of appraisee : Signature of appraiser :
Date :	Date :	Date :

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B.2. BEHAVIOURAL ASSESSMENT: This section shall constitute 20% of the final score)

Analysis and assessment of critical attributes required to perform the activities

The appraisee should only be rated in areas that are relevant to his/her job. The maximum points per attribute and/or quality are ten (10). Under each attribute, the 10 points should be allocated in a manner that shows the areas of strengths and weaknesses of the appraisee. Ten (10) is the maximum per attribute and one (1) lowest. Please indicate the relevant points in the boxes provided, thereafter add up the points, and indicate the total. The score out of 20 will be got by; dividing the total score by the total maximum score for all attributes rated. Then multiply the result by 20.

CORE RESPONSIBILITIES

ACTIVITIES

APPRAISEE SCORE(10)

JUSTIFICATION

APPRAISER'S COMMENTS

AGREED SCORE

Provision of Youth Friendly services: (Client Service Orientation / Public relations)

• Trained and knowledgeable in Youth friendly services.

• Respects young people and their needs.

• Acknowledges the provision of privacy in delivering services to adolescents

• Provides extra time to discuss the special needs of adolescents.

Creativity:

• He / She is always proactive (does things before being asked or forced to by events).

• Always optimize resources to produce more with the available resources by introducing easier or faster ways of doing business.

• Demonstrates attention to detail and accuracy while producing outputs.

• Always generate new workable ideas for consideration.

Team Work :

• Often engages colleagues while handling matters that require their opinion before deciding on final position.

• Is always willing to put in extra effort when needed to support others.

• Recognizes team differences (different ways of doing business in different business areas).

• Proactively shares relevant information and learning ideas with colleagues.

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B2 (Count 1)

CORE RESPONSIBILITIES	ACTIVITIES	APPRAISEE SCORE(10)	JUSTIFICATION	APPRAISER'S COMMENTS	AGREED SCORE
Respect:	• Treats other people with civility and dignity. • Is sensitive to other viewpoints and promotes an atmosphere of mutual respect. • Refrains from behaviour or language that is exclusionary or offensive in nature. • Seeks to understand perspectives of different groups within the Authority.
Communication:	• Appropriately expresses own opinion in a clearand confident manner with timely feedback. • Listens carefully and waits forthe other persons to first finish their intended message before responding. • Chooses the appropriate channels to direct message to intended recipients. • Consistently presents grammatically correctwritten information, and in the appropriate style.
Integrity:	• Displays honesty and is upright all the time in all ways. • Complies with all Institutional policies and procedures at all times. • Holds self and others accountable for their actions and behaviors. • Is reliable, dependable and trusted.
Decision Making:	• Demonstrates appropriate initiative • Knows decisions to make at his/her level and identifies information required to take appropriate decision. • Analyses problem thoroughly. • Shows patience and determination in resolving problems. • Remains accountable to his / her decision. • Makes informed decisions; considering potential implications

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B2 (Count 2)

CORE RESPONSIBILITIES

ACTIVITIES

APPRAISEE SCORE(10)

JUSTIFICATION

APPRAISER'S COMMENTS

AGREED SCORE

Excellence:

• Maintains positive attitudes at all times.

• Thinks analytical (gives opinion / idea after thoroughly thinking through it).

• Maintains good corporate image at all times (dressing appropriately, wearing IDs, maintaining neatness of body and dressings, punctual at work and manages his or her time well while on duty).

• Always performs assignments beyond the expected targets.

SUMMARY OF RATINGS / SCORES FOR B.2

APPRAISEE SECTION	APPRAISER SECTION	APPRAISEE AND APPRAISER DIALOGUE SECTION
Total Score by Appraisee :	Total Score by Appraiser :	Total Agreed Score :
Signature :	Signature :	Signature of appraisee : Signature of appraiser :
Date :	Date :	Date :

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SECTION C: OVERALL PERFORMANCE AND REVIEW COMMENTS:

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TOTAL RATINGS / SCORE FOR B.1 AND B.2

APPRAISEE SECTION	APPRAISER SECTION	APPRAISEE AND APPRAISER DIALOGUE SECTION
Total Score by Appraisee :	Total Score by Appraiser :	Total Agreed Score :
Signature :	Signature :	Signature of appraisee : Signature of appraiser :
Date :	Date :	Date :

C.1. 1st LEVEL APPRAISER'S OVERALL COMMENTS FOR THE CYCLE INCLUDING DEVELOPMENT NEEDS WHERE APPLICABLE


C 1.1 The appraisal was discussed with appraisee on (Date)
C 1.2 Did you agree with the appraisee about his/her activities and outputs prior to the commencement of this appraisal period?
C 1.3 If NO please explain
C 1.4 If YES, indicate the highlights of your discussion with the appraisee
C 1.5 Based on the appraisal you have made in C 1(C 3) and D 4 above indicate
C 1.6 Areas of strength that enhanced employee performance
C 1.7 Appraisee’s areas for improvement
C.1.8 What contribution has the appraisee made beyond the normal requirements of his/her job?
C.1.9 What contribution has the appraisee made beyond the normal requirements of his/her job?
C.1.10 Indicate the appraisee’s potential for development in his/her career with NTIHC
C.1.11 Specific actions or improvements that I have agreed with appraisee to increase his/her effectiveness in the next appraisal review period
C.1.11 What specific actions should management take to improve or motivate the appraisee to perform more efficiently?

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C.2 APPRAISEE'S OVERALL COMMENTS FOR THE CYCLE

C.2.A: Facilitating and Constraining factors


C 2.1 Briefly state factors that facilitated your performance, i.e., contributed positively towards your performance
C 2.2 Briefly outline major constraints/problems encountered in the execution of assignment and duties
C 2.3 In which areas do you need support?
C 2.4 Suggest measures that could be taken at your personal level as well as at Management level to fully utilize your perceived strengths
C 2.5 What contribution have you made to NTIHC beyond the normal requirement of your job?
C 2.6 In view of your strengths and potential, what are your expectations from NTIHC

C.2.B: Appraisee comments after Discussion with the Appraiser;


C 2.7 Do you agree/partly disagree/disagree with the appraiser’s evaluation. Please tick one box	AGREE PARTLY DISAGREE DISAGREE
C 2.8 If you partly disagree/disagree, please explain.
C 2.9 Specific actions or improvements that I have agreed with the appraiser to enhance my effectiveness in the next appraisal review period.

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2nd LEVEL APPRAISEER'S OVERALL COMMENTS FOR THE CYCLE

GENERAL RECOMMENDATIONS		JUSTIFY / SPECIFY
Confirm appointment	YES NO
Renew contract	YES NO
Others

APPRAISE	NAME	SIGNED	DATE
1st LEVEL APPRAISER
1st LEVEL APPRAISER

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E. PERFORMANCE OBJECTIVES AND TARGETS FOR THE NEXT APPRAISAL PERIOD.

At the beginning of the appraisal period, the appraiser and appraise shall jointly agree on key activities and outputs. The scores per activity/output should also be agreed on depending on the weight attached to the different activities.

NO.	PERFORMANCE OBJECTIVES	ACTIVITIES	TARGETS	TIME FRAME

F. PERFORMANCE LEVELS AND SCORES.

Overall assessment guide .

Total score	91% and above	81% - 90%/th>	60 - 80%	50 - 59%	49% and below
Remarks	Outstanding	Very good	Good	Fair	Unsatisfactory

The assessment is out of 100%; Section B1 carries 80 Marks, Section B2- 20 marks. The scores range from 1 to 10; representing 10 – 100%.


91% and above	Model	• Consistently exceeds all set targets throughout the performance period. • All the time accomplishes the tasks before the set timelines. • The performance outputs are consistently of a higher quality over and above the expected standards. • Continuously seeks out and Introduces new ways of doing business that improves processes, outputs and efficiency.
81% - 90%	Very Good	• Consistently exceeds most of the set targets by more than 80% throughout the performance period. • Most of the time accomplishes the targets before the set timelines • Performance outputs are most of the time of a higher quality over and above the set standard • Most of the time seeks new ways of doing business and improving processes, output and efficiency.
60% - 80%	Good	• Consistently meets all the set targets within the set times throughout the performance period and delivers 100% of the set targets. • Performance Outputs are consistently accurate and of an acceptable quality.
50% - 59%	Fair	• Meets some of the set targets within the performance period. • Performance outputs are accurate and of an acceptable quality.
<50%	Poor	• Is unable to meet the set targets during the performance period. • Performance outputs are below expected standards and require re-work most of the times

G. COMMENTS BY THE PROGRAM DIRECTOR:

I have read the appraisal report for (Appraisee’s Name):	Comments:

Name	Title	Signature	Date

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