NAZARENUS COLLEGE AND HOSPITAL FOUNDATION, INC.
Pre–School, Elementary, Junior High School & Senior High School Education
WORK IMMERSION PERFORMANCE APPRAISAL
STUDENT’S NAME:____________________________________________________ STRAND:
____________
Partner Institution:____________________________________________________________________________________
Address:_________________________________________________________ Position:_______________________
Office Assignment:________________________________ Work Immersion Supervisor:____________________________
Training Period:_________ to _________ Total No. of Hours Rendered:_________
Directions. For each behavioral item listed within the competency bands, with 5 being the most and 1 is the least, please
select the evaluation most suited.
5 Outstanding Performance exceeds the required standards
4 Very Satisfactory Performance fully met job requirements. Was able to perform what was
expected of a person in his/her position.
3 Satisfactory Performance has met the required standard. Can perform duties with
minimal supervision.
2 Fair Performance partially meets the required standard. Less than satisfactory
could be doing better.
1 Needs Improvement Performance does not meet the required standard. Major improvement
needed.
NA Not Applicable Performance indicator is not relevant to the job.
COMPETENCIES 5 4 3 2 1
TEAM WORK
1.Consistently works with others to accomplish goals and tasks.
2. Treats all team members in a respectful courteous manner.
3. Actively participates in activities and assigned tasks required.
4. Willing to work with team members to improve team collaboration on continuous basis.
5. Considers the feedback and views of team members when completing an assigned task.
TEAM WORK Total Score/5
COMMUNICATION 5 4 3 2 1
1. Actively listens to supervisor and/or co-workers.
2. Comprehends written and oral information.
3. Consistenly delivers accurate information both written and oral.
4. Reliably provides feedback as required, both internally and externally.
COMMUNICATION Total Score/4
ATTENDANCE AND PUNCTUALITY 5 4 3 2 1
1. Is punctual on a regular basis.
2. Maintains good attendance.
3. Informs supervisor in a timely manner when absenteeism and tardiness may occur.
ATTENDANCE AND PUNCTUALITY Total Score/3
PRODUCTIVITY/RESILIENCE 5 4 3 2 1
1. Consistently produces quality results.
2. Meets deadlines and manages time well.
3. Can do multitasking.
4. Can work under pressure and delivers required tasks.
5. Effective and efficient in time management.
6. Efficiently informs supervisor of any challenges or hindrances related to give task or
assignment.
PRODUCTIVITY/RESILIENCE Total Score/6
INITIATIVE/PROACTIVITY 5 4 3 2 1
1. Completes assignments with minimum supervision.
2. Completes tasks independently and consistently.
3. Seeks support as need arises.
4. Recognizes and takes immediate action to effectively address problems and
opportunities.
5. Engages in continuous learning.
6. Contributes new ideas and shares skills to improve the department/organization.
INITIATIVE/PROACTIVITY Total Score/6
JUDGEMENT/DECISION MAKING 5 4 3 2 1
1. Analyzes problems effectively.
2. Has the ability to make creative and effective solutions to problems.
3. Demonstrates good judgment in handling routine problems.
JUDGEMENT/DECISION MAKING Total Score/3
ATTITUDE 5 4 3 2 1
1. Offers assistance willingly.
2. Shows a positive work attitude.
3. Shows sensitivity to and consideration for other’s feelings.
4. Accepts criticism positively.
5. Shows pride in work.
ATTITUDE Total Score/5
DEPENDABILITY/RELIABILITY 5 4 3 2 1
1. Has the ability to follow through and meet deadlines.
2. Has commitment for his/her actions.
3. Can adjust easily to changes in workplace.
4. Displays high level performance at all times
DEPENDABILITY/RELIABILITY Total Score/4
PROFESSIONALISM 5 4 3 2 1
1. Respects persons in authority.
2. Uses all tools, equipment, and facilities responsibly.
3. Follows all policies and procedures when issues and conflict arises.
4. Physical appearance conforms with the workplace and placement rules.
PROFESSIONALISM Total Score/4
Weighted Equivalent
OVER ALL RATING Average Grade
SUMMARY OF SCORES
CRITERIA WEIGHTED
AVERAGE
TEAM WORK
COMMUNICATION
ATTENDANCE AND PUNCTUALITY
PRODUCTIVITY/RESILIENCE
INITIATIVE/PROACTIVITY
JUDGMENT/DECISION MAKING
ATTITUDE
DEPENDABILITY/RELIABILITY
PROFESSIONALISM
Over-all Weighted Average
Equivalent Grade
REMARKS: (Comments/Suggestions)
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Student’s Signature:____________________ Date:__________________
Work Immersion Supervisor’s Signature over Printed Name:____________________________
Transmutation Table
Computed Weighted Average Equivalent Grade
4.20-5.00 100
3.40-4.19 95
2.60-3.39 90
1.80-2.59 85
1.00-1.79 80
