Household Staff Feedback

Family Name

Employee Name

Date Hired

Please rate your household staff employee’s performance in these categories:

Fulfills Tasks and Responsibilities ExcellentAbove AverageSatisfactoryUnsatisfactory

Follows Directions ExcellentAbove AverageSatisfactoryUnsatisfactory

Punctuality/Reliability ExcellentAbove AverageSatisfactoryUnsatisfactory

Attitude/Self-Motivation ExcellentAbove AverageSatisfactoryUnsatisfactory

Flexibility ExcellentAbove AverageSatisfactoryUnsatisfactory

Good Judgment ExcellentAbove AverageSatisfactoryUnsatisfactory

Communication ExcellentAbove AverageSatisfactoryUnsatisfactory

Overall Rating ExcellentAbove AverageSatisfactoryUnsatisfactory

Please list the strengths possessed/exhibited by your household staff employee:

Please list any areas of concern which you feel need improvement:

May we disclose your comments to your household staff employee?

YesNo