Household Staff Feedback Please take the time to complete this evaluation form regarding your household staff employee. 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