Reference Check Template

Requisition #: Applicant Name: Date:

Conducted by: Reference Name: Reference Phone:

Sample Script:Hi, My name is _________________ and I’m calling to conduct a reference check for (applicant name), who is being considered for the position of (position title, branch and ministry).

Your name has been provided by (applicant name) as a reference. I would like to first confirm that you have supervised (applicant name), and also that you are prepared to provide a reference. I will be verifying certain employment information as well as his/her skills, abilities and competencies that are related to this position.

The reference check will take approximately 20-30 minutes to complete. Is this a good time for you? If not, when is the earliest time possible, at your convenience, that I can book time with you to continue this conversation?

Briefly explain the responsibilities of the job and the key factors you will be assessing through the reference check

Important to mention: Please note that this reference will be used in the overall evaluation of the applicant and will affect the final rating. The information you provide can be given to the candidate, in full or part, should it be requested under the Freedom of Information and Protection of Privacy Act.

Select the competencies, skills and abilities you want to assess using the reference check method. Please review the job profile/ selection criteria/ interview notes to select the factors you want to assess. You may also use the Sample list of skills, abilities and competencies in the table below. Please ensure the factors you choose to assess are required for the optimal job performance.

Sample skills, abilities and competencies (factors) that could be assessed in the reference check. Please choose the factors that apply to the job.

Sample Skills Sample Abilities Sample CompetenciesCommunication Skills Ability to multitask and handle high volume of work Problem Solving & JudgementOrganizational Skills Ability to meet deadlines Holding People AccountableAdministrative Skills Ability to deal with irate, upset, hostile people LeadershipComputer Application Skills Ability to exercise tact and diplomacy Developing OthersCustomer Service Skills Attention to detail, high level of accuracy Teamwork and CooperationInterpersonal Skills Ability to manage programs/ projects Service OrientationRecords Management Skills Ability to lead staff Fostering Trust

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Reference Check Template

General Questions (not to be rated)

I have a few general questions to ask, followed by questions related to job specific factors and then overall factors.

1. In what capacity was the applicant employed by your company / Ministry / Branch?

2. What were the dates of employment? 3. Please describe the applicant’s key

responsibilities during this time.

Notes:

Rating guide: Gather and collect all information from the referee and complete the rating after the call. Reference check can be Pass/ Fail or Scored. Below is a sample scoring grid as well as descriptors for Pass/Fail. Do not ask the reference to provide a score.Rating:Poor- Unacceptable 0-1 Weak - Less than acceptable 2 Satisfactory Acceptable 3 Full performance Very good 4 Exceptional 5FAIL FAIL PASS PASS PASS Significantly below criteria

required for successful job performance

No answer or inappropriate answer

Demonstrates counter-productive behaviours that have negative outcomes or consequences

Insufficient for performance requirements

Generally does not meet criteria relative to quality and quantity of behaviour required for successful job performance

Does not demonstrate a sufficient range of skills for handling of situation

Should be acceptable for effective performance

Meets criteria relative to quality and quantity of behaviour required for successful job performance

Demonstrates a sufficient range of skills for handling the situation

More than acceptable for effective performance

Consistently demonstrates better than average level of performance

Requires limited direction in complex situations

Exceeds expectations in most to all areas with superior results

Requires limited direction in complex situations

Job Specific Questions:In the table below insert the skills, abilities & competencies and corresponding questions you wish to ask. Below are 2 examples of ability statements and corresponding questions. These are samples only and should be replaced with factors that are specific to the job. To be most effective, include a maximum of 4 to 5 areas to cover.

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Reference Check Template

Question 1:REPLACE THIS SAMPLE WITH YOUR OWN QUESTIONExample: Ability to meet deadlines while managing a high work volume In this role the position is required to be very well organized, and able to manage a full and diverse workload while meeting deadlines.

Please describe ____________‘s ability to organize and manage their workload. How well does ____adapt to changing priorities?

Probing Questions: In what aspects does candidate excel? In what aspects could candidate improve? Has this been discussed with him/her? What development is underway to achieve this improvement? How long has he/she been working on improvement and what is the progress.

Notes:

Rating:

Question 2:REPLACE THIS SAMPLE WITH YOUR OWN QUESTIONExample: Ability to identify, monitor and assess problems. In this role the position is required to identify, monitor and assess problems and determine appropriate course of action.

Please describe _______________’s ability to identify, monitor and assess problems and determine course of action.

Probing Questions: In what aspects does candidate excel? In what aspects could candidate improve? Has this been discussed with him/her? What development is underway to achieve this improvement? How long has he/she been working on improvement and what is the progress.

Notes:

Rating:

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Reference Check Template

Question 3:Skill, ability/ competency assessed: ________________

Insert the question:

Notes:

Rating: Question 4:Skill, ability/ competency assessed: ________________

Insert the question:

Notes:

Rating:

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Reference Check Template

Overall Performance Questions:If you have any questions or concerns after completing this section, please contact your Hiring Advisor or contact AskMyHR

1. What would you say were ________key strengths and challenges?

2. Have there been any issues or performance concerns with this individual?

If yes, please explain when were these issues identified? When were they discussed with the individual? What development is underway to achieve improvement? How long has he/she been working on improvement and what is the progress/ outcome?

Notes:

Rating:Reliability – Punctuality and Attendance:

3. Did the applicant’s ability to attend work on a regular and consistent basis and when needed ever effect the operation of the office or their ability to satisfactorily perform their responsibilities and duties?

Please explain any concerns/ or absence patterns. Did you discuss these issues or concerns with the individual? If yes, what improvement have you observed?

Notes:

RatingStandards of Conduct:

4. How effective was this individual in ensuring that their conduct met the highest standards in matters such as confidentiality, loyalty, honesty, integrity, impartiality, workplace behaviour and conflicts of interest?

If there were any issues or concerns in this regards, please explain. Did you discuss these issues or concerns with the individual? If yes, did improvement result?

Notes:

Rating:

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Reference Check Template

In closing:

1. Is there anything else of relevance that I have not asked you that you think I should know about this individual’s performance at work? Any comments you wish to add?

Notes:

2. Would you rehire this individual? Why, or why not?

Notes:

Note: Thank the referee for taking the tame to provide the feedback. Provide your name and number in case they wish to call you back with further information.

Overall Rating SummaryQuestion and Factor you are assessing Max

RatingScore or Pass/Fail

Question 1.

Question 2.

Question 3:

Question 4:

Overall Performance:

Reliability

Standards of Conduct

Minimum Pass Mark (if applicable) Total Score (if applicable) or Overall Pass/ Fail rating

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Reference Check Template

Additional Sample questions – for each lead question you can add probing questions such as: “In what aspects did the candidate excel? In what aspects could candidate improve?  Has this been discussed with him/her?  What development is underway to achieve this improvement?  How long has he/she been working on improvement and what is the progress?”

1. Teamwork and Cooperation: In this position the successful applicant must be able to work cooperatively as part of a team and support team decisions.  How well did this employee demonstrate this in your organization?  Please explain or describe.

2. Relationship building: Please describe ____________‘s ability to establish and maintain professional (effective, respectful, collaborative) liaisons/relationships, with colleagues, clients and supervisor(s).

3. Communication Skills: Please describe ___________’s ability to communicate effectively - both verbally and in writing in a clear, concise manner (inter-personal, group settings, email, letters/memos, reports, presentation, etc.). 

4. Managing stress/ workload: Please describe ____________‘s ability to effectively cope with and manage through periods of high workload and/or workplace stress.  What stress management and/or self-care abilities have you observed being demonstrated.  What abilities have you observed with respect to coping with and managing through staff and co-worker stress and challenging behavior?

5. Leadership/ Management Skills: Please describe ___________’s staff leadership ability and provide an example.  In what leadership areas is he/she very effective?  What areas of leadership need further development?  Describe how he/she addresses and deals with challenging employees.  Provide an example of his/her success in managing employee performance.  In what areas of employee coaching and development is he/she very effective?  What effective approaches has he/she demonstrated to develop or improve employee performance? 

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