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JOIN OUR TEAM!
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BOARD / ADMIN APPLICATION
VOLUNTEER DIVISION
JUNIOR SQUAD DIVISION
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BUILDING USE APPLICATION
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Semi - Annual Employee Evaluation & Performance Officer Review
Semi - Annual Employee Evaluation & Performance Review
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Name
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First
Last
LINE OFFICER ONLY: Paid staff provider you are evaluating
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Only Lieutenants and Deputy Chiefs fill out this section
Please complete the online self-evaluation form below.
3- Exceeds 2- Meets 1- Needs Improvement
Accountability- Accepts responsibility for actions, answerable to consequences
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3
2
1
Cooperation- Has ability to get along with coworkers and management
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3
2
1
Punctuality & Attendance- Is rarely late/absent, arrives on time, works required hours
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3
2
1
Attitude/Respectfulness- Shows initiative, optimism, and politeness
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3
2
1
Accepts Criticism- Has ability to learn from suggestions and change behavior
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3
2
1
Flexibility- Has capacity to respond to changing situations and expectations
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3
2
1
Policy & Procedures- Follows organization's policies and procedures
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3
2
1
Completion of Duties- Successfully completes checks, chores & PCRs in timely manner
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3
2
1
Patient Interaction- Ensures high-quality care, respects patients’ dignity and confidentiality
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3
2
1
Quality of Work- Is thorough, accurate, and with full completion
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3
2
1
Willingness to Develop Skills- Desires to take on challenges and learn new techniques
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3
2
1
Communication Skills- Conveys information effectively and efficiently
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3
2
1
Organizational Skills- Has capacity to stay on track and use time effectively
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3
2
1
Confidentiality- Does not discuss internal events with coworkers
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3
2
1
Appearance/Dress Code- Demonstrates a professional and well-kept appearance
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3
2
1
Appearance of Work Area- Keeps work area & ambulance neat and orderly
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3
2
1
Conflict Resolution- Seeks constructive approaches to resolving workplace issues
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3
2
1
Safety- Contributes to a safe and secure environment by following established procedures
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3
2
1
Job Knowledge- Demonstrates working knowledge of procedures and health
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3
2
1
OSHA & HIPPA Compliance- Understands regulations & completes training in timely manner
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3
2
1
Expense Management- Not wasting supplies & equipment
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3
2
1
Inventory- Has ability to keep ambulances fully stocked before/after calls
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3
2
1
iPad/Applications- Effectively sets up iPad apps during beginning of shift
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3
2
1
Radio Manners- Sounds professional & successfully uses proper scripts/techniques
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3
2
1
Availability- Is available to work any shift as needed & submits availability (per diem staff)
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3
2
1
Scheduling- Submits availability, vacation time prior to set deadline
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3
2
1
Scene Safety/Size Up- Makes sure crew is wearing proper PPE & is aware of surroundings
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3
2
1
Patient Flow- Not sitting on scene longer than needed; no transport delay
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3
2
1
Insurance/Forms- Collects proper insurance/face sheets for each call
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3
2
1
Station Tidiness- Keeps living room, bathrooms, & other rooms cleaned and organized
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3
2
1
Independance- Able to perform all duties w/o being directed; including during active calls
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3
2
1
Apparatus Operations- Able to operate apparatus in a safe manner
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3
2
1
Proper Demeanor- Always remains calm & focused during all types of calls
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3
2
1
Cardiac Arrest- Able to perform all care & scene management w/o issues.
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3
2
1
Proper Conduct- Remains professional at all times in public; proper attitude & dress code
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3
2
1
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