DSP Annual Evaluation Step 1 of 10 10% Name First Last Position Title:Hire Date Date Format: MM slash DD slash YYYY Review DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SupervisorDepartment/ Location: Professional KnowledgeThe DSP possesses skills and knowledge to perform the job competently. Demonstrates knowledge of personal information for each person, including programs and procedures.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating CommunicationThe DSP communicates effectively with the people supported, coworkers, parents, and guardians. Organized and expresses ideas and information clearly, using appropriate and efficient methods of conveying the information.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Teamwork/Interpersonal Skills:The DSP establishes appropriate rapport with people supported, co-workers, parents, and guardians to facilitate effective teamwork. Is sensitive to the needs, feelings, and capabilities of others. Approaches others in a non-threatening and pleasant manner and treats them with respect.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Attendance:The DSP works shifts and attends staff meetings, in-services and trainings with regular, reliable attendance and timeliness. Follows call in procedures & guidelines.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Health & SafetyThe DSP works to promote health and safety at all times. This includes administration of medications, use of lifts, safe transfers, vehicle use, meeting dietary needs and general cleaning.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Integrity/Ethics/Positivity/Respect:The DSP maintains a high level of character and a professional attitude in alignment with the DSP Code of Ethics. The DSP has positive interactions with people supported and coworkers; demonstrates dignity and respect toward others. Is able to follow and promote BHSSC’s core values.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Documentation:The DSP completes all necessary documentation accurately and timely. Maintains confidentiality.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Excellence & Quality:The DSP completes high quality work according to the specifications outlined in Policy and Procedures manual. Pays close attention to details. Keeps complete records. Has a strong sense of quality and knows how to achieve it.DSP Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting RatingSupervisor Rating1.00 - Exceeds expectations and performance frequently exceeds all job requirements.2.00 - Needs improvement and performance meets some but not all job requirements.3.00 - Below standard and performance consistently fails to meet job requirements.Comments Supporting Rating Supervisor’s Overall Evaluation/Summary:This performance evaluation has been reviewed and discussed.Employee/DSP SignatureDate Date Format: MM slash DD slash YYYY Supervisor SignatureDate Date Format: MM slash DD slash YYYY CAPTCHA