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1. Employee Information: Basic details of the caregiver including name, employee ID, license number, and period of evaluation
2. Evaluator Information: Details of the person conducting the evaluation, including their position and relationship to the caregiver
3. Core Competencies Assessment: Evaluation of essential caregiving skills including patient care, medical knowledge, and safety protocols
4. Professional Conduct: Assessment of work ethics, punctuality, attendance, and adherence to policies
5. Communication Skills: Evaluation of interaction with patients, families, and healthcare team members
6. Technical Skills: Assessment of specific medical procedures, documentation, and use of equipment
7. Performance Metrics: Quantitative measures of performance including patient satisfaction scores and task completion rates
8. Overall Rating: Final performance score and category classification
9. Comments and Recommendations: Specific feedback and areas for improvement
10. Acknowledgment: Signatures of evaluator and employee, confirming review of evaluation
1. Cultural Competency: Assessment of cultural awareness and sensitivity, particularly relevant for caregivers working with diverse patient populations
2. Language Proficiency: Evaluation of language skills, important when working with specific patient communities
3. Leadership Skills: Assessment of leadership capabilities, relevant for senior caregivers or team leaders
4. Emergency Response: Evaluation of performance in emergency situations, particularly relevant for caregivers working in high-risk settings
5. Specialized Skills: Assessment of specific skills related to specialized care areas (e.g., dementia care, pediatric care)
1. Performance Rating Scale: Detailed explanation of the rating system and scoring criteria
2. Job Description: Specific duties and responsibilities of the caregiver position
3. Required Competencies Checklist: Detailed list of required skills and competencies for the role
4. Development Plan Template: Format for documenting agreed-upon improvement goals and timeline
5. Incident Report Log: Record of any significant incidents or achievements during the evaluation period
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