Information
Personnel Section
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Associate Name:
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ID Number:
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Employee Status:
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Prepared by
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Observation Date / Start Time:
Reason for Observation
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New Employee
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New Job Assignment
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Job Performance Review
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Other (Describe)
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Other reason for observation
Skill in Methods
Method Grades
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Not Observed (NOB) = activity not observed
Needs IMP = somewhat clumsy, fumbles, hesitations (loses time)
Meets = steady, proficient, average (neither gains or loses time) -
Safety remarks required
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Stop Time:
Safety Elements
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1.Operator keeps both hands on controls at all times?
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2. Operator is aware of his surroundings?
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3.Operator looks in the direction of travel?
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4.Operator honks his horn when exiting the trailer?
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5.Operator keeps his/her entire body within the vehicle compartment?
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6.Operator does not drive into a trailer that is not illuminated.(Trailer is not dark and floor / product can be seen?
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7. Operator keeps his work area neat, organized and free of debris?
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9. Return directly to staging location to obtain next pallet
Method Steps
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1. Receive assignment from Supervisor / Ops desk
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2. Prepare trailer for loading
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3. Open dock door and apply dock plate
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4. Enter pre-loading info as directed by VMU
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5. Verify product is in good condition and address damages
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6. Obtain and scan pallet for loading
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7. Travel directly to loading door and scan door as loading
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8. Place product on truck
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Scoring Safety Elements
Needs IMP = does not comply and/or understand
Meet (M) = understands and performs most of the time -
10. When loading complete, retract dock plate and close dock door
Performance Estimate
Performance Grades
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Scoring Performance Estimate
Below (B) = less than 0 Meet (M) = greater than 0 but less than +10 Exceed (E) = greater than +10 -
Skills in Methods
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Method Characteristics:
Below = somewhat clumsy, adds motion, fumbles, hesitation, errors
Meet = follows methods, proficient, consistent, steady, average
Exceed = precise and smooth, quick and sure, reduces motions, smart, perfection -
Effort Level
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Effort Characteristics:
Below = slow, not best effort, slow motion
Meet = steady, enthusiastic, average
Exceed = fast, focused, sometimes too much -
Time Utilization
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Utilization Characteristics:
Below = does not try to avoid delay, exceeds delay allowances, stops working to talk
Meet = minimizes delay by following the methods, continues working while talking, sometimes successful at avoiding delay
Exceed = eliminates delay by eliminating motion, always works - never talks, always successful at avoiding delay
Overall Performance Score
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Performance Estimate =
- 20
- 10
- 0
- -10
- -20
- -30
Coachable Moment
Review Coachable Behavior with associate
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5-Step Coaching Model
1) Convey Positive Intent
2) Describe behavior and actions observed
3) State impact of desired coachable behavior(s)
4) Ask associate to respond
5) Focus discussion on solution -
Was a Coachable Moment Observed:
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Coachable category:
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Coachable Behavior (Additional notes about employee's performance during this observation)
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Follow-Up required:
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Planned date for Follow-up:
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Associate Signature:
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Supervisor Signature:
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Quality Audit by Managers
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CMO Quality Feedback
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Manager Signature:
