Housekeeper Feedback

Family Name

Housekeeper Name

Date Hired

Please rate your housekeeper’s performance in these categories:

Fulfills Tasks and ResponsibilitiesExcellentAbove AverageSatisfactoryUnsatisfactory

Meets Your Quality and Frequency StandardsExcellentAbove AverageSatisfactoryUnsatisfactory

Follows DirectionsExcellentAbove AverageSatisfactoryUnsatisfactory

Punctuality/ReliabilityExcellentAbove AverageSatisfactoryUnsatisfactory

Attitude/Self-MotivationExcellentAbove AverageSatisfactoryUnsatisfactory

FlexibilityExcellentAbove AverageSatisfactoryUnsatisfactory

Good JudgmentExcellentAbove AverageSatisfactoryUnsatisfactory

CommunicationExcellentAbove AverageSatisfactoryUnsatisfactory

Overall RatingExcellentAbove AverageSatisfactoryUnsatisfactory

Please list the strengths possessed/exhibited by your housekeeper:

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

May we disclose your comments to your housekeeper?

YesNo