Per Form No.

029
CAPITOL MEDICAL CENTER, INC.
Quezon City, Philippines

EMPLOYEE PERFORMANCE ANALYSIS

(Non-Supervisory Employee)

Date: _______________, 20_________

Name of Employee: ______________________________ Classification: _________________

Department: ____________________________________ Date Employed: _______________
Previous Salary: _________________________________ Present Salary: ________________
How long is he under your supervision?_____________________________________________
How long has this employee worked in this position? __________________________________
How long this employee has been promoted to this position? ____________ Yes ____ No ____
Period covered by this analysis? From: __________________ To: ____________________

SCORING KEY
INSTRUCTIONS
(Please Read Carefully Before Accomplishing)

1. Evaluate the employee’s work performance and attitude during the period under review. His
work performance during other periods should not influence this rating. Consider the entire
period covered by this rating. For every rating given, have specific reasons in mind to justify
each rating.

2. Base your ratings on facts, not mere impressions. It is necessary to concentrate on one
factor at a time. Rating in one factor should not influence rating in another. Adopt a definite
standard for comparison of employee in your section or department doing similar work.

3. Take plenty of time to rate your personnel. Do not be biased by prejudice or pity. The
efficiency of your section or department depends largely on your fair appraisal of those
working under your supervision. Do not over rate your friends, nor under rate those hostile
to you.

4. Disregard length of service, age, educational attainment, training, previous ratings, and
other similar factors and those that do not relate directly to the employee’s job
performance. Forget about the employee’s capabilities that are not used in his present work,
just because he is lawyer, accountant as well. Disregard those extra attainments, if
irrelevant to his present job.

5. Discuss your evaluation with the concerned employee and let him/her conform to your
appraisal before you forward the form to Personnel.

6. “BE FAIR – HONESTLY RATE EACH INDIVIDUAL TO THE BEST OF YOUR ABILITY”
 APPRAISAL OF PERFORMANCE

I. SUMMARY OF PERFORMANCE
(Check the appropriate box and indicate total rating)
91 to 100 points Does an exceptionally good job
Outstanding …………………………………(_____ pts.)
76 to 90 points Does more than adequate
Good …………………………………………..(_____ pts.)
41 to 75 points Does a fair job, but needs improvement
Fair …………………………………………….(_____ pts.)
up to 40 points Does a poor job
Unsatisfactory ……………………………..(_____ pts.)
II. PROMOTIONAL POTENTIAL (Please answer all questions)
A. In your opinion, is this employee doing the type of work best suited to his ability?
YES _____ No _____ . If not, explain _______________________________________________
______________________________________________________________________________
B. Does this employee have potential for supervisory or charge position?
Very Likely _____ May or May Not _____ Very Unlikely _____
C. Does this employee have potential for upgrading to a higher position of more responsibility, other
than a supervisory or charge position? YES _____ No _____ . If YES, explain
_______________________________________________________________________________
_______________________________________________________________________________
D. In your evaluation, what are his strongest characteristics?
_______________________________________________________________________________
_______________________________________________________________________________
E. What are his weakest characteristics?
_______________________________________________________________________________
_______________________________________________________________________________
F. How can he improve his performance?
_______________________________________________________________________________
_______________________________________________________________________________
III. EMPLOYMENT RECOMMENDATION
(Check appropriate boxes based on your final recommendation)

RETAIN PROMOTE DEMOTE TERMINATE

IV. Additional remarks or recommendation of rating officials:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Rated by:
_________________________
Date: ____________________
___________________
EMPLOYEE’S SIGNATURE
____________________________ Concurred by:
DATE
__________________________
Date: _____________________

Approved by:

________________________________
Date: ___________________________

Rcd 3/22/07