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Caring Acres - Annual Evaluation
Employment Information
Employee Name*
Employee Title/Position*
Supervisor Name*
Assessment
Please rate the following questions on a scale of 1 (poor) to 5 (excellent):
I deliver the highest quality of work, following established Caring Acres processes, policies, and procedures*
Why do you feel that you don`t deliver the highest quality of work? What resources can we provide?*
I complete my work with little to no coaching from my supervisor*
Why do you feel that you don`t complete your work without coaching?*
I communicate well and clearly with my coworkers and supervisor*
Why don`t you feel that you communicate well? What can we do to help you improve?*
I am committed and passionate*
Why don`t you feel that you are committed and passionate? What can we do to change that?*
I enjoy working at Caring Acres*
What ideas do you have that can make Caring Acres a better place to work?*
I have the resources I need to do my job well*
What additional resources can we provide to help you do your job well?*
People are held accountable for the quality of work they produce*
Why don`t you feel that people are help accountable? What would you like to see from leadership?*
My supervisor gives me priase and recognition when I do a good job*
Please explain what your supervisor does to recognize you so that we can continue and build upon it?*
I feel personally driven to help this organization succeed*
Why do you think you feel this way?*
I feel supported by the administrators office and feel like I can take concerns to them*
You are what makes Caring Acres great and we hate that you feel this way. What can we do to change?*
Senior leadership (ie: Kris and Jeremy Lange) are genuinely interested in employee opinions and ideas*
You are what makes Caring Acres great and we hate that you feel this way. What can we do to change?*
Goal Setting
List your most significant accomplishments or contributions in the last year.*
What activities have you initiated or participated in to encourage resident participation.*
Caring Acres motto is "Where Caring Never Grows Old" What does this mean to you?*
Are there any aspects of your work where you have not done as well as you had hoped and why?*
List at least 1 goal for the upcoming year.*
Continuous Improvement
Please answer the following questions:
Do you understand the duties and expectations required of your position(s) with Caring Acres*
Yes No 
Please explain*
Is there anything your supervisor can do to better support you and increase your job satisfaction*
Yes No 
Please explain*
Would you like to add any additional comments to your evaluation?*
Yes No 
Additional Comments:
Certification and Filing Instructions
I certify that the information that is contained in this review is true and accurate.
Full Name:*
Date
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