Information
Personnel Section
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Facility Name:
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Associate (Last name, First name)
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Employee Status:
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ID Number:
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Conducted by:
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Document No.
Reason for Observation
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New Employee (Temp / New Hire in probation period)
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Select last completed week of job probation period (1-12).
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
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New Job Assignment
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Job Performance Review
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Was associate a low performer last week?
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How many weeks as low performer, in this task?
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Other (Describe)
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Other reason for observation
Skill in Methods
Method Grades
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Not Applicable (N/A)
Below (B) = somewhat clumsy, fumbles, hesitations (loses time)
Meet (M) = steady, proficient, average (neither gains or loses time)
Exceed (E) = safely reduces motion, quick, smooth (gains time) -
Observed Activity:
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Start Time:
Method Steps
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1. Prepare put away tally for product to be put away.
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2. Travel to staging location in most direct route.
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3. Writes the pallet info and storage location product is being placed.
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4. Verifies pallet is in good condition for storage.
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5. Operator travels to storage location in most direct route, with forks at proper travel height.
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6. Confirms location is correct.
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7. Raises forks to needed height without undue hesitation.
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8. Places pallet correctly in location. Pallet is placed straight in location and at proper depth in bay.
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9. Lowers forks to travel height without undue delay.
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10. Proceeds to next assignment as directed in an efficient manner.
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Stop Time:
Safety Elements
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Safety remarks required
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Scoring Safety Elements
Below (B) = does not comply and/or understand
Meet (M) = understands and performs most of the time
Exceed (E) = understands and performs all the time -
1.
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2.
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3.
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 =
- 30
- 20
- 10
- 0
- -10
- -20
- -30
- -40
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 Manager
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CMO Quality Feedback
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Manager Signature: