THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM
FOR INTERNAL USE ONLY
Template No.: T293
Template Title: Department Performance Review & Planning Template (Annual)
Related Research Case IDs / Cluster: _______
Linked Templates / Policies: _______________
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only
T293 – Department Performance Review & Planning Template (Annual)
Purpose:
Use this template for the yearly department review. It records results, problems, risks, and the plan for next year.
A) Department information
Department name: __________________________________________
Head of department (name/role): _____________________________
Review year: ________
Period covered: ____ / ____ / ______ to ____ / ____ / ______
Team size: Staff ______ Volunteers ______ Interns ______
Main sites/locations covered: ________________________________
Prepared by (name/role): ____________________________________
Date submitted: ____ / ____ / ______
B) This year’s goals (from last year’s plan)
List 3–7 goals that were approved last year.
C) Results summary (what we delivered)
C1. Main results (short, simple):
Result 1: _______________________________________________
Result 2: _______________________________________________
Result 3: _______________________________________________
Result 4: _______________________________________________
Result 5: _______________________________________________
C2. Results vs plan (table)
| Goal / activity | Planned (Yes/No) | Done (Yes/No/Partly) | Evidence (report, minutes, photos, logs) | Comments |
|---|---|---|---|---|
| 1 | ||||
| 2 | ||||
| 3 | ||||
| 4 | ||||
| 5 |
D) Key indicators (optional but recommended)
(If you use an indicator scorecard, link to it here.)
Scorecard used? Yes [ ] No [ ]
Scorecard file/code (e.g., T281): ___________________________
3 key indicators for this department and the current score:
| Indicator (short name) | Baseline | Current score | Trend (Up/Down/Stable) | Comment |
|---|---|---|---|---|
E) What worked well (strengths)
Write 3–6 points (real examples).
F) Problems and gaps (what did not work)
Write facts, not blame. Keep it simple.
Problem/gap: _______________________ Cause (best guess): _______________________
Problem/gap: _______________________ Cause (best guess): _______________________
Problem/gap: _______________________ Cause (best guess): _______________________
Complaints or concerns received (if any, summary only):
Number of cases: ________
Main themes (no names): __________________________________________
G) Risks (next 12 months)
Tick and write short notes.
Safety/security risk [ ] Note: __________________________________
Relic care / conservation risk [ ] Note: _________________________
Finance/budget risk [ ] Note: ___________________________________
Staff/volunteer capacity risk [ ] Note: __________________________
Reputation/communication risk [ ] Note: _________________________
Partner/MoU risk [ ] Note: ______________________________________
Facility/equipment risk [ ] Note: ________________________________
Other: __________________ [ ] Note: _____________________________
Top 3 risks (priority):
____________________________ 2) ____________________________ 3) ____________________________
H) Next-year plan (what we will do)
H1. Priority objectives (3–7)
H2. Action plan table
| Objective / action | Owner (role) | Start date | Deadline | Needed resources | Success indicator (simple) |
|---|---|---|---|---|---|
I) Resource needs (request)
I1. Budget needs (summary):
Estimated total: ___________________ Currency: ______
Main budget items (list): __________________________________________
I2. Staffing and time needs:
New roles needed? Yes [ ] No [ ] If yes: __________________________
Volunteer needs: _________________________________________________
Peak workload periods (months): ___________________________________
I3. Equipment/facility needs:
J) Training and support needs
List the trainings needed next year (link to annual training plan if used).
| Training topic | Target group | Why needed | Preferred time | Owner |
|---|---|---|---|---|
K) Partnerships and stakeholders
Key partners this year (list): _______________________________________
Partnership issues/risks (if any): ___________________________________
Stakeholder feedback summary (staff/volunteers/community/visitors):
L) Final comments and sign-off
Department head statement (3–6 lines):
Prepared by: _______________________ Signature: ______________ Date: ____ / ____ / ______
Reviewed by (Director/ED): __________________ Signature: ______________ Date: ____ / ____ / ______
Board note (if needed): _______________________________________________
