Caregiver Performance Evaluation Form for the United States
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Caregiver Performance Evaluation Form
"I need a Caregiver Performance Evaluation Form for our assisted living facility that focuses heavily on memory care specialization and includes specific metrics for dementia patient care, to be implemented across our 50-person care team by March 2025."
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1. Employee Information: Basic information about the caregiver being evaluated including name, position, hire date, and department
2. Evaluation Period: Time period covered by the evaluation and date of review
3. Core Competencies Assessment: Evaluation of essential caregiving skills including patient care, medical knowledge, communication, and safety protocols
4. Performance Metrics: Quantifiable measures of job performance including attendance, punctuality, documentation accuracy, and patient satisfaction scores
5. Overall Rating: Summary assessment of performance with final rating and evaluator comments
1. Professional Development Goals: Section for documenting future growth objectives and training needs, used for full-time employees or when developing career advancement plans
2. Client Feedback Summary: Section for compilation of client/patient feedback, included when direct client feedback is available and relevant
3. Disciplinary Actions: Section for documentation of any disciplinary measures taken during the evaluation period, included when there have been performance issues
1. Schedule A - Skills Checklist: Detailed list of required skills and competencies with assessment ratings
2. Schedule B - Training Records: Documentation of completed training and certifications during the evaluation period
3. Schedule C - Incident Reports: Summary of any reported incidents or notable events during the evaluation period
4. Schedule D - Performance Improvement Plan Template: Standard form for documenting needed improvements and action plans when performance falls below expectations