1. Specialized Skills Assessment: For caregivers working with specific patient populations (e.g., elderly, pediatric, mental health) or specialized medical equipment

2. Leadership Capabilities: For senior caregivers or those in supervisory positions

3. Emergency Response Evaluation: For caregivers working in high-acuity settings or where emergency response is crucial

4. Cultural Competency: For caregivers working in diverse communities or with specific cultural groups

5. Training Completion Record: Section tracking completed training programs and certifications during the evaluation period

6. Patient/Family Feedback: Including feedback from care recipients and their families when appropriate and available

1. Appendix A: Detailed Rating Criteria: Comprehensive breakdown of performance indicators and rating criteria for each competency area

2. Appendix B: Job Description: Current job description against which performance is measured

3. Appendix C: Competency Checklist: Detailed checklist of required skills and competencies specific to the role

4. Appendix D: Professional Development Resources: List of available training programs and resources for improvement

5. Appendix E: Performance Improvement Plan Template: Standard template for documenting specific improvement goals and action steps

6. Appendix F: Incident Report Summary: Summary of any reported incidents or concerns during the evaluation period