THE CITY UNIVERSITY OF NEW YORK PUBLIC SAFETY SERVICE PERFORMANCE AND PROMOTION APPRAISAL (checkbox) Unchecked Probationary Sergeant 6 months Probationary Sergeant 9 months Probationary Sergeant 12 months Other (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked Probationary Patrol Officer 6 months Probationary Patrol Officer 9 months Probationary Patrol Officer 12 months NAME: (text) TITLE/RANK: (text) COLLEGE: (text) PERIOD COVERED BY THIS REPORT FROM: TO: (text) (text) SHIELD NO.: (text) PAY PLAN: (text) IMPORTANT NOTE In fairness to the employee and The City University of New York, consider each item carefully before rating. Judge the employee on the entire period covered by this report, not upon isolated incidents alone. Base your rating on the employee’s performance in comparison with what is considered standard performance for the particular position rather than in comparison with other employees. ATTENDANCE LAST FIVE YEARS YEAR 20____ (text) 20____ (text) 20____ (text) 20____ (text) 20____ (text) PUNCTUALITY TOTAL TIMES LATE DURING THE LAST 12 MONTHS ___________ (text) ABSENCE OCCASIONS (text) (text) (text) (text) (text) DAYS LOST (text) (text) (text) (text) (text) I.O.D.’S (INJURED ON DUTY) (text) (text) (text) (text) (text) FACTORS HUMAN INTERACTION UNACCEPTABLE (CLEARLY BELOW STANDARD) AVERAGE (MEETS STANDARD) MARGINAL (APPROACHES STANDARD) ABOVE AVERAGE (ABOVE STANDARD) OUTSTANDING (AMONG THE VERY BEST) 1. JOB KNOWLEDGE Possesses the knowledge andskills required to perform the job 2. QUALITY OF WORK AccuracyCompleteness ~ ~ Efficiency 3. ABILITY TO LEARN Learns quickly ~ ~ Remembers what is taught 4. WRITTEN REPORTS Reports are complete Reports are accurate Reports are clear Reports are concise 5. RESPONSE TO INCIDENTS Responds quickly Handles properly 6. DECISION MAKING Possesses judgment required to make good decisions and is willing to make them 7. DRIVING ABILITY Alert and safe Number of accidents in the last 12 months____ OVERALL RATING: (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (text) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked COMMENTS ON TECHNICAL COMPETENCE (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) FACTORS HUMAN INTERACTION 8. RELATIONS WITH SUPERIORS Supportive but willing to express opinions 9. RELATIONS WITH COWORKERS Operates as part of a team 10. RELATIONS WITH SUBORDINATES Maintains high morale (Sergeants and Lieutenants only) 11. RELATIONS WITH PUBLIC AND STUDENTS Treats campus community with respect, dignity andtactfulness while carrying out all responsibilities OVERALL RATING: UNACCEPTABLE (CLEARLY BELOW STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked MARGINAL (APPROACHES STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked AVERAGE (MEETS STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked ABOVE AVERAGE (ABOVE STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked OUTSTANDING (AMONG THE VERY BEST) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked COMMENTS ON HUMAN INTERACTION (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) FACTORS HUMAN INTERACTION 12. MATURITY Responsible and stable 13. INITIATIVE Takes steps to prepare himself/herself independently and without urging 14. DEPENDABILITY Can be counted on to perform effectivelywith minimum supervision 15. ORAL EXPRESSION Speaks clearly Speaks concisely 16. APPEARANCE Uniform, equipment and personal grooming 17. PHYSICAL FITNESS Weight and condition 18. FLEXIBILITY Adapts to changes in circumstances and ideas 19. RESOURCEFULNESS Ability to handle nonroutine matters in acapable manner 20. INTEGRITY Adherence to a high code of ethical andmoral standards OVERALL RATING: UNACCEPTABLE (CLEARLY BELOW STANDARD) ~ (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked MARGINAL (APPROACHES STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked AVERAGE (MEETS STANDARD) ~ (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked ABOVE AVERAGE (ABOVE STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked OUTSTANDING (AMONG THE VERY BEST) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked COMMENTS ON PERSONAL CHARACTERISTICS (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) FACTORS HUMAN INTERACTION 21. SUPERVISORY SKILLS Effectively plans, organizes and motivates Other to accomplish organizational goals 22. MANAGEMENT ORIENTATION Supportive of organization and its goals OVERALL RATING: UNACCEPTABLE (CLEARLY BELOW STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked MARGINAL (APPROACHES STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked AVERAGE (MEETS STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked ABOVE AVERAGE (ABOVE STANDARD) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked OUTSTANDING (AMONG THE VERY BEST) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked COMMENTS ON SUPERVISORY/MANAGEMENT ABILITY (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) RELATED DATA DISCIPLINARY INFORMATION, COMMENDATIONS, AWARDS (if applicable): (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) RECOMMENDATION FOR PROMOTION ( Complete one of the following statements when rating for promotion only). The best performer at one level is not necessarily the best individual to promote to the next level. In making your recommendation for promotion, consider the knowledge, skills and attitudes required for success as a public safety superior officer. A. STRONGLY RECOMMENDEDThis individual possesses C. NEEDS DEVELOPMENTThis individual has potential for position the knowledge, skills and personal characteristics to be an outstanding of _________ but needs further development at the present level. B. RECOMMENDEDThis individual possesses the knowledge, D. LACKS POTENTIALThis individual lacks potential at present for skills and personal characteristics required to be a position of____________________________________________________ (checkbox) Unchecked (checkbox) Unchecked (text) (text) (checkbox) Unchecked (checkbox) Unchecked (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) REVIEWED (College Public Safety Director) DATE (text) REVIEWED (College Personnel Director) DATE (text) RATER’S SIGNATURE COUNSELOR’S SIGNATURE DATE (text) RATER’S TITLE/RANK (text) DATE (text) (text) EMPLOYEE’S SIGNATURE DATE (text) (text) GENERAL COMMENTS BY RATER (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) REVIEWED (Univ. Director of Public Safety) DATE (text) (text)