APAS FORM 1

APAS FORM 1
REPUBLIC OF ZAMBIA

CONFIDENTIAL Issued By: THE PERMANENT SECRETARY

PUBLIC SERVICE MANAGEMENT DIVISION

ANNUAL PERFORMANCE APPRAISAL SYSTEM (APAS) FORM

Please read these instructions carefully:

1. This Appraisal Form is confidential and an official record (i.e. not to be communicated to unauthorized persons)
2. No officer should attempt to use this form unless he/she is well acquainted with the detailed instructions of the
appraisal process given in the APAS USER GUIDE and the APPENDIX to this form.
3. As the Supervisors and their respective subordinates complete this form, r should bear in mind that the
information they are providing is subject to open discussion.
4. The Appraisee should complete Part I. Human Resources and Administration should initiate the process by
ensuring that the APAS forms are given to the officers to be appraised.
5. Both the supervisor and the job-holder must separately and independently complete their appropriate parts of
the APAS form, excluding Part 4. A date must then be set by the Supervisor for the appraisal interview, which
should normally be within 24 hours from the date of completion of the form.
6. At the end of the appraisal interview the job-holder should provide his/her comments as required in Part 4.
7. After the appraisal interview, 3 copies of completed forms must be made and distributed as follows: one copy to
be retained by the department/division, one copy to be retained by the ministry and one copy to be sent to
Public Service Management Division. Job holders wishing to retain a form should be allowed to photocopy it.
8. Appropriate follow-up action should then be taken on the outcome of the Appraisal.
9. All entries on the APAS Form must be made in ink.

PART1: PERSONAL PARTICULARS (To be completed by the Appraisee but initiated by the Human
Resources and Administration Department.)

ANNUAL PERFORMANCE APPRAISAL FOR THE PERIOD:

(Month) JANUARY 2023 TO (Month). DECEMBER

2023

STAFF NO:

PMEC EMPLOYEE NO: (AS IT APPEARS ON PAYSLIP)

0000000

SURNAME: Nvvvvvvv OTHER NAMES: xxxxxccccc

JOB TITLE: ENVIRONMENTAL HEALTH TECHNOLOGIST SALARY SCALE: G

DATE OF PRESENT APPOINTMENT: xxxxxx

MINISTRY/PROVINCE: MINISTRY OF HEALTH, LUSAKA PROVINCIAL HEALTH OFFICE

DEPARTMENT: PUBLIC HEALTH

STATION: HOSPITAL Xyz

PART 2: WORKPLAN AND PERFORMANCE (To be completed by Appraisee or Supervisor as indicated)

2.1 Purpose of The Job (To be completed by Appraisee)

To maintain and improve environmental health standards in order to prevent and abate public
health nuisances.

2.2 Key Result Areas and Principal Accountabilities (To be completed by Appraisee)

KEY RESULT AREA PRINCIPAL ACCOUNTABILITY

1. MANAGEMENT Coordinate public health activities in order for the institution to

conform to the national set standards.

2. POLICY Interprets and implement effective, policies, regulations and

procedures in order to ensure compliance with set standards

Adheres to and implements effectively, the environmental standards

3. WASTE MANAGEMENT and guidelines to ensure institutional and public safety.

4. INFECTION Orients timely, members of staff on infection prevention practices in

PREVENTION order to ensure adherence.

Undertakes periodic water sampling for bacterial and chemical

5. WATER, SANITATION analysis and inspection of food premises and handlers in order to
AND FOOD SAFETY determine chemical compositions.

Undertakes timely, implementation of capacity building interventions

6. CAPACITY BUILDING in order to impart appropriate skills and knowledge to junior staff.

7. RESEARCH Undertakes regularly, research projects in order to generate

information and ensure evidence-based practice.

8. PERFORMANCE Ensure timely development of sectional work plans and individual

APPRAISAL work plan in order to monitor and evaluate performance.

Targets set during appraisal period and the rating (The Appraisee completes the first two columns for KRA and Targets, as agreed 2.3 with Supervisor while the rating
Be completed by the Supervisor using the key* below)

KEY RESULT AREA TARGET RATING

1. MANAGEMENT 1. Three (1) Public Health meeting with Neighborhood committees conducted

quarterly and minutes submitted to the Zonal Environmental Health Officer

quarterly.

2. Conducted one (1) health Centre committee meetings on quarterly basis

and submit minutes to the Zonal Environmental Health Officer monthly.

3. Supervised all outdoor staff daily.

4. Conducted one (1) building maintenance sessions quarterly and share the

report with the Zonal EHO and PHS quarterly

2. POLICY

Conducted (3) inspection of public premises per week and submit a report to

the Zonal Environmental Health Officer.

3. WASTE MANAGEMENT 1. Ensured consistent provision of sharp boxes and clinical waste bins and bin

liners in appropriate departments and rooms at all times

2. Maintained good standards of all waste disposal facilities at the health facility

daily.

4. INFECTION PREVENTION 1. Held (1) quarterly infection prevention meeting with the epidemic
 preparedness committee and submit minutes to the Zonal EHO

2. Oriented members of staff on quarterly basis on infection prevention

and control

5. WATER, SANITATION AND FOOD 1. Collected three (3) bacteriological water samples weekly and submit a

SAFETY comprehensive report to the Zonal Environmental Officer.

2. Collected three (3) water samples for chemical analysis weekly and

submit report to the Zonal EHO

3. Inspected (3) food premises and food handlers weekly and submit

reports to the Zonal EHO.

4. Conducted (4) inspections of water points weekly and submit a report

to the zonal EHO.

6. CAPACITY BUILDING Conducted (1) capacity building sessions annually.

7. RESEARCH Conducted (1) research/ survey project annually

8. PERFORMANCE APPRAISAL Developed an individual work plan annually.

*KEY: Above Target = 3 on Target = 2 below Target = 1 Overall Target Rating** =

**Overall rating is total rating divided by the number of targets

2.4 Comments by the Appraisee on targets;
For Public
a) Achieved: Service
Management
I have mate 80% of my targets. Division
Official use
only

b) Not Achieved:

20% of my targets were not mate due to lack of some field tools.

Signature: ............................................. Date: 19/02/2020

2.5 Comments by the Supervisor on targets;

a) Achieved:

b) Not Achieved:

Signature: .........................................Date: .....................................

2.6 Additional contributions made by the Appraisee to the Ministry/Department (to be

Completed by the Supervisor)

Signature: .............................................Date: ........................................

PART 3: PERFORMANCE COMPETENCIES (To be completed by Supervisor using rating key* below)

3.1 COMPETENCIES/ATTRIBUTES RATING*

a. Management/Supervisory skills:-
Ability to guide others towards meeting set goals and objectives

b. Job knowledge:
Level of understanding and ability to apply knowledge and skill to perform the job.

c. Quality of Work:
The degree to which an employee applies himself/herself in performing work to the required
standards i.e. completes his/her work with accuracy, minimal error.

d. Promptness in completing assignments:

Completing assignments on time.

e. Dependability:
Ability to follow instructions, maintain good conduct, time-keeping and devotion to government
duties
f. Accountability:
Willingness to shoulder responsibility and to be answerable for the achievement/non-
achievement of objectives.

g. Initiative and Creativity:

Ability to be innovative, resourceful, creative, promote new ideas and resolve problems within or
outside set guidelines.

h. Communication skills:
Ability to communicate effectively both orally and in writing.

I. Tact and Courtesy:

The employee's sensitivity, integrity, politeness and temperament in dealing with others.

j. Attitude:
Interest shown towards the job.

k. Adaptability:
Ability to cope with changing ideas, work environment, technologies as well as ability to get
along with superiors, peers and subordinates

l. Team work:
Co-operation with fellow workers and supervisors and promoting an environment which
encourages open communication and consensus.

Overall Rating on Competencies/Attributes**

3.2 What type of follow-up action do you recommend for the appraisee?
For Public
Service
Management
Division
Official use
only

Date: ...........................................Signature: ..............................................................

Name:..........................................Job Title: ...............................................................

*Rating Key: Outstanding = 4 Good = 3 Fair = 2 Poor = 1 Non Applicable = X

**Overall rating on Competencies/Attributes is total rating divided by the number of Competencies/Attributes rated.
PART 4: COMMENTS ON APPRAISAL
4.1 Comments by Appraisee
The appraisal ratings and comments were discussed with my Supervisor and my comments are:

Signature: ..................................................Date: ....................................................................

4.2 Comments by Countersigning Officer (Refer to paragraph 13 of the User Guide. Delete which is not applicable)
I, as countersigning officer, agree/disagree with the appraisal made by the supervisor because of the
following reasons:

Signature: .......................................Name: ................................................................

Title: ...............................................................................Date: ...................................

4.3 Comments by Permanent Secretary (Delete which is not applicable)

I, Permanent Secretary, agree/disagree with the appraisal made by the supervisor because of the
following reasons:

Signature: .......................................Name: ................................................................

Date: ...............................................

PART 5: ACTION TO BE TAKEN BY PSMD (To be completed by Public Service Management Division)
5.1 APAS Form Received by PSMD

Date: .........................................................Signature: ................................................

5.2 APAS Information Computerized

Date: .........................................................Signature: ...............................................

5.3 APAS Form Referred To Staff File

Date: .........................................................Signature: ................................................

(When completed please send back the cut-off slip below to originating station)

Cut here

STAFF NO:

PMEC EMPLOYEE NO: (AS IT APPEARS ON PAYSLIP) 0000000

Name: XXXXX. XXXXX

Job Title: ENVIRONMENTAL HEALTH TECHNOLOGIST

Ministry/Province: MINISTRY OF HEALTH/ LUSAKA

Department: PUBLIC HEALTH Station: HOSPITAL XYZ

Date Form Received: ............Date Information Computerized: ... ........... .

Signature......................................................................... Date: .......................................

Job Title: ......................................................................................................................... .....

 THE INTERPRETATION OF THE APAS FORM
PART 1:

1. It is important to ensure that relevant files and documents are consulted when completing this part.

PART 2:

1. Purpose of the Job: This is a brief statement on why the job exists/what it intends to achieve, as
stated in the Job Description.

2. Key Result Areas and Principal Accountabilities: These should be as stated in the Job
Description.

3. Targets set during Appraisal Period against each Key Result Area: These should be as
agreed with the supervisor. When completing Part 2.3, the appraisee should take note that one KRA
can have more than one target.

4. Comments by Appraisee on targets achieved/not achieved: This should give an account of

attributes/factors
That contributed to the achievements/non-achievements of targets set.

5. Comments by Supervisor on targets achieved/not achieved: This should give an account of

the attributes/factors that contributed to the achievement/non-achievement of targets set.

6. Additional Contributions made by Appraisee: This should give a brief account on the significant
contributions made, if any, by the appraisee to the Ministry/department.

7. When making comments on targets not achieved, the supervisor and appraisee may ensure that
they
Take into account: - Financial Resources, Equipment and tools, Staffing levels, Health
related, Unrealistic
Targets, Lack of support/co-operation, Negligence, Incompetence.

PART 3:

1. The follow up action to be taken is a recommendation made by the supervisor taking into account the
rating on both the targets and performance competencies. This recommendation could either relate
to skills development, reward or sanction.

PART 4:

1. In Part 4.1 job-holders are expected to be open and free to express themselves, giving reasons for
their
Comments on whether they agree or disagree with the assessment by the supervisor.

2. In parts 4.2 and 4.3 the countersigning officer and the Permanent Secretary, respectively, are
expected to approve
Or otherwise the submissions from the supervising officer.

PART 5:

1. PSMD is expected to promptly update the human resource information data bank, for use in
effectively managing the
Human resource in the Public Service. PSMD will also acknowledge receipt of the Appraisal form.