Companion Employee Performance Evaluations

Employee Name:

Supervisor Name/Title Completing Eval:

Type of Evaluation:

Outstanding (5): Consistently exceeds job requirements and essential function
Commendable (4): Frequently exceeds job requirements and essential function
Satisfactory (3): Meets job requirements and essential function
Needs improvement (2): Often fails to adequately meet job requirements and essential function
Unsatisfactory (1): Consistently fails to adequately meet job requirements and essential function.

Follows appropriate hand washing guidelines per Agency policy

Follows appropriate visit “bag technique”

Follows the “Do’s and Don’t” of the agency

Assists in maintaining a healthful, safe environment for the Consumer

Ensures payroll is accurately and properly processed.

Notifies the office of changes to Consumer schedule (days or times)

Develops and controls the processing of all accounts payable.

Notifies the office/supervisor of Consumer changes in situation

Documents accurately and appropriately on visit notes

Submits weekly paperwork timely without reminders

Maintains a professional appearance/nametag while visiting Consumers

Represents our Agency in a professional manner to outside visitors

Conducts themselves in a polite, courteous and pleasant manner

Follows all our Agency’s policies and procedures

Demonstrates reliability and accountability when accepting cases

Participates in the Agency QA process as requested

Notifies Agency of emergencies, sickness, and other imminent occurrences that may affect the Consumer caseload as quickly as possible relative to the event’s occurrence.

Submits written time requests 2 weeks or more in advance of planned time off.

Comments:

Goals to be reached by next evaluation:

Employee Signature

Date

Evaluator’s Signature/Title

Date