Appendix 1
Structured Reference Checking Form 

This template, designed for the position of Assistant Deputy Minister, may be adapted to suit any occupational level and the specific needs of your organization. Choose among the different parts, questions and competencies proposed those that are most relevant to the position you are assessing. For instance, the behavioural indicators for the Key Leadership Competencies can be tailored to the appropriate level of leadership by copying and pasting the behaviours for each competency from the Key Leadership Competencies Website of the Office of the Chief Human Resources Officer. For other levels, both the competencies and behaviours would need to be replaced.

Structured Reference Checking Form

Assistant Deputy Minister Template

Reference Check	Position:		
	Organization:		
	Date:		
Applicant	Name:		
	Phone #:		
	E-mail:		
Referee	Name:		
	Title:		
	Phone #:		
	E-mail:		
Reference Checker	Name:		
	Phone #:		
	E-mail:		

Part 1: Preliminary questions

The following open-ended questions are designed to provide the reference checker with a clear understanding of the referee’s working relationship with the applicant, as well as a general overview of the applicant’s strengths and areas for development.

1.	Please describe your working relationship with the applicant (supervisor, client, peer, etc.) and what was the time frame during which you worked with them?

Relationship:

# of months/years worked together: ______________

time frame:
	
2.	What were the applicant’s primary responsibilities, in order of importance?	
3.	What would you describe as the applicant’s key strengths?	
4.	On what areas of development could the applicant focus?	
5.	How did the applicant relate to others on the job?

6.	Can you briefly describe the applicant’s leadership style? 

	
7.	What was the applicant’s reason for leaving?	

Part 2: Verification questions

The purpose of the following questions is to verify and/or complete information provided by the applicant in previous assessments (e.g., application form, résumé, interview).  

1.	What is the applicant’s language of preference at work?

   French      English      Both  
	
2.	Is the applicant proficient in any other languages? 

	
3.	What is the highest level of education attained by the applicant?

	
4.	Can you describe any additional training or work experience that the applicant has acquired that would be an asset to the current position?

	
5.	Are you aware of any other organizations for which the applicant has worked? 

	
6.	What was the applicant occupational group and level (e.g., EX-1) while working for your organization?  Please explain, if necessary.

7.	Are you personally aware of any behaviour that, in your view, may constitute a breach of conduct on the part of the applicant (for example, in terms of interpersonal relations, ethical behaviour or business practices)?	
8.	Please ask any additional questions for verification stemming from the following sources:

a) Application form

	
b) Résumé

	
c) Interview

	
d) Other assessments

	

Part 3: Competency assessment

The evaluation of leadership competencies is, essentially, a two-step process. The referee is first asked to describe the performance of the applicant in terms of the specific behaviours and areas for development that are relevant to each of the four Key Leadership Competencies. Based on the evidence that is provided, the assessor is then asked to assign a rating for each competency.

Collecting behavioural evidence

First, read aloud the list of behavioural indicators for the competency, then ask the referee to describe specific actions, if any, that the applicant has taken to demonstrate that competency. Remind the referee to include: 
•	A description of the situation, task or context with which the applicant was faced;
•	The applicant’s actions; and
•	The impact of the applicant’s actions. 

Second, ask the referee whether they are “aware of any areas that could be developed in relation to the competency”, being as specific as possible.  

When collecting behavioural evidence, the reference checker’s primary responsibility is to take detailed notes and to ensure sufficient coverage of the behavioural indicators. The reference checker may need to ask follow-up probe questions such as “Can you tell me more about that?” or, if the referee responds with a generalization or evaluation, “Can you give me a specific example?”.

Assigning competency ratings 

Once the interview is complete, the assessor should provide a numerical rating on the following five-point scale for each competency, based on the information that is provided. That is, given the behavioural evidence presented by the referee, how did the applicant perform on this competency? 

1	2	3	4	5	X	
Greatly below expectations	Below expectations	Met expectations	Exceeded expectations	Greatly exceeded expectations	Unable to observe	

To help inform their assessment, assessors should ask:
•	How many of the behavioural indicators for the competency were evident?
•	How were the behaviours demonstrated in the referee’s examples in terms of complexity and impact?
•	Do the behavioural examples provided meet the performance expectations for the target position?
•	How would the applicant’s developmental areas affect their performance in the target position?

Judgements made for each competency assessed should be accompanied by a rationale that describes whether the behaviours demonstrated by the applicant cover, or do not cover, the behavioural indicators of the competency and with what quality.

Using the rating scale. When assigning competency ratings, the assessor should compare the referee’s description of the applicant’s behaviour with the behavioural indicators provided. As these indicators are tailored to the requirements of the target position, these are the expectations that must be met for an applicant to receive a “3”, or “met expectations”. If the evidence is of greater quality and depth than what is described in the behavioural indicators, a rating of “4” or “5” may be given. Similarly, evidence that is of less quality and depth relative to the behavioural indicators would merit a rating of “2” or “1”. 

Unable to observe. If the referee has not had the opportunity to observe any of the behavioural indicators for a competency during their experience with the applicant, the assessor is asked to record a rating of “Unable to Observe” (denoted by an “X” on the rating scale). It is important to note the difference between a rating of “1” and “Unable to Observe”, namely that a “1” is given when an applicant has had opportunities to demonstrate a given competency, but did not do so in those circumstances, while “Unable to Observe” applies when the referee’s contact with the applicant did not allow them to observe that aspect of the applicant’s behaviour.

Key Leadership Competencies Definitions

Values & Ethics
Integrity & Respect

Public Service (PS) leaders serve Canadians, ensuring integrity in personal and organizational practices and respect people and PS principles, including democratic, professional, ethical and people values. They build respectful, bilingual, diverse and inclusive workplaces where decisions and transactions are transparent and fair. They hold themselves, their employees and their organizations accountable for their actions.  

Strategic Thinking
Analysis & Ideas

PS leaders advise and plan based on analysis of issues and trends, and how these link to the responsibilities, capabilities and potential of their organization. They scan an ever-changing, complex environment in anticipation of emerging crises and opportunities. They develop well-informed advice and strategies that are sensitive to the various needs of multiple stakeholders and partners, reflect the strategic direction of the PS and position the organization for success.  

Engagement
People, Organizations, Partners 

PS leaders engage people, organizations and partners in developing goals, executing plans and delivering results. They lay the groundwork by building coalitions with key players. They mobilize teams, building momentum to get things done by communicating clearly and consistently, investing time and energy to engage the whole organization. They use their negotiation skills and adaptability to encourage recognition of joint concerns, collaboration, and to influence the success of outcomes. They follow and lead across boundaries to engage broad-based stakeholders, partners and constituencies in a shared agenda and strategy.

Management Excellence
Action Management, People Management, Financial Management  

PS leaders deliver results by maximizing organizational effectiveness and sustainability. They ensure that people have the support and tools they need and that the workforce as a whole has the capacity and diversity to meet current and longer-term organizational objectives. They align people, work and systems with the business strategy to harmonize how they work and what they do. They implement rigorous and comprehensive human and financial resources accountability systems consistent with the Management Accountability Framework (MAF). They ensure that the integrity and management of information and knowledge are a responsibility at all levels and a key factor in the design and execution of all policies and programs.

Other Competencies 

Any additional competencies relevant to the target position may be defined here.

Values and Ethics- Integrity and Respect	
Behavioural indicators (choose the indicators specific to the position)
•	Demonstrates Values and Ethics, including the Code, in personal behaviour 
•	Integrates Values and Ethics, including the Code, into branch practices 
•	Reflects a commitment to citizens and clients in own and branch activities 
•	Provides fearless advice and acts with the courage of their convictions 
•	Builds organizational values into branch policies and programs 
•	Builds and promotes a bilingual, diverse, inclusive branch, based on Official Languages and Employment Equity policies 
•	Builds and promotes a safe and healthy, respectful branch, free of harassment and discrimination 
•	Models transparency and fairness 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency? 

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:	

Strategic Thinking- Analysis	
Behavioural indicators (choose the indicators specific to the position)
•	Frames questions and analyses with a thorough understanding of legislation and the ADM role 
•	Seeks DM, government, national, regional, global and technical perspectives on sector issues 
•	Recognizes critical or sensitive issues and makes links to priorities 
•	Distinguishes between critical and trivial factors in making judgments 
•	Analyzes setbacks and seeks honest feedback to learn from mistakes 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency? 

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:

Strategic Thinking- Ideas	
Behavioural indicators (choose the indicators specific to the position)
•	Provides quality judgment and policy advice to the DM 
•	Contributes to the elaboration of the collective/DM vision 
•	Articulates the vision in terms of own mandate 
•	Develops innovative solutions to non-traditional problems 
•	Develops strategies to manage the scope and pace of change 
•	Develops strategies that are effective in the short and longer term 
•	Encourages constructive questioning of policies 
•	Envisions possibilities without detailed information 
•	Exercises sound professional judgment based on analysis and consultation, as needed 
•	Teaches and learns from others 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency? 

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:	

ENGAGEMENT — People, Organizations, Partners	
Behavioural indicators (choose the indicators specific to the position)
•	Cultivates effective relationships and networks with other departments and agencies, clients, citizens, unions, central and regional employees and other levels of government 
•	Provides communication links up, down and throughout the organization and networks 
•	Communicates with and encourages candour and clarity 
•	Communicates and interprets external contexts to position branch, team and individual contributions 
•	Demonstrates and elicits trust by seeking and providing honest and constructive feedback 
•	Actively listens to and understands impact on others 
•	Influences outcomes by negotiating win-win solutions, compromising and resolving conflict 
•	Tailors approach to context, e.g., collaborative for consensus building, directive in crisis 
•	Inspires a commitment to excellence by demonstrating passionate personal commitment 
•	Works with the departmental/agency and PS-wide ADM community to deliver on shared objectives 
•	Creates an open, positive environment to stimulate open discussion 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency?

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:	

Management Excellence— Action Management	
Behavioural indicators (choose the indicators specific to the position)
•	Leads change that maximizes results in the branch, organizationally and in the sector 
•	Acts as a steward for the entire department/agency, not just their own branch 
•	Identifies and communicates priorities, milestones, timelines, performance measures, clear accountabilities and performance agreements for DGs 
•	Designs and manages a strategic risk management framework 
•	Coordinates national and regional priorities, planning and performance 
•	Aligns priorities and resources 
•	Follows through on the branch business plan from planning, implementing, monitoring and evaluating to reporting 
•	Integrates comptrollership, MAF, federal legislation, regulations and policies into branch practices 
•	Fulfils obligations of branch management accountabilities 
•	Integrates HR, finance, IT, IM, and communications issues into planning and actions 
•	Revises goals and plans to reflect changing priorities or conditions 
•	Commits to a course of action despite incomplete information, if required 
•	Makes decisions, initiates urgent actions and remains calm in crisis situations 
•	Recognizes and acknowledges errors and makes corrections 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

Are you aware of any areas that could be developed by the applicant in relation to this competency?

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:	

Management Excellence— People Management	
Behavioural indicators (choose the indicators specific to the position)
•	Develops HR strategy for succession planning 
•	Creates expert teams to address specific or crisis issues 
•	Sets clear expectations, monitors, evaluates, rewards and develops performance 
•	Recognizes people’s accomplishments and best efforts 
•	Gives honest feedback, encourages learning and manages non-performance 
•	Deals with HR problems decisively and effectively 
•	Recognizes the importance of and supports the DG community 
•	Balances complementary strengths in teams 
•	Builds leadership throughout the branch 
•	Guides and develops people through appraisals, career planning and development 
•	Consults with support services prior to changing HR protocols 
•	Implements rigorous HR systems and fulfils obligations of HRM accountabilities 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency?

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:	

Management Excellence— Financial Management  	
Behavioural indicators (choose the indicators specific to the position)
(Choose up to four indicators)
•	Allocates resources transparently and establishes a culture of ongoing re-allocation 
•	Aligns business drivers with financial management regime 
•	Promotes innovative approaches to deal with fiscal restraint 
•	Integrates comptrollership processes and promotes due diligence 
•	Reviews and reacts to the results of audits and evaluations 
•	Continuously monitors performance and seeks efficiencies
•	Fulfils obligations of accountabilities for branch financial management 
•	Provides objective, credible and timely reporting to the DM 
•	Consults with support services prior to changing financial protocols 	

Evidence/Comments	
Context, situation or task:

Measures or actions taken:

Impact:

	
Are you aware of any areas that could be developed by the applicant in relation to this competency?

To be completed by the assessor after the interview:
1	
2	
3	
4	
5	
X	

Greatly below expectations	
Below expectations	
Met expectations	
Exceeded expectations	
Greatly exceeded expectations	
Unable to observe	

Rationale:
	
Part 3: Additional comments from referee

Is there anything else that you would like to add that would help us learn more about the applicant?

	

Part 4: Overall Suitability

Would you appoint this person now to this position?

  Yes    No

Please explain:

For what types of positions or organizations would the applicant be most suitable?

	

	

Part 5: Comments from the Reference Checker

	
Part 6:  Summary Ratings	
Competency	Rating	
Values and Ethics	1	2	3	4	5	Unable to observe	
Strategic Thinking- Analysis	1	2	3	4	5	Unable to observe	
Strategic Thinking- Ideas	1	2	3	4	5	Unable to observe	
Engagement	1	2	3	4	5	Unable to observe	
Management Excellence- Action Management	1	2	3	4	5	Unable to observe	
Management Excellence- People Management	1	2	3	4	5	Unable to observe	
Management Excellence- Financial Management	1	2	3	4	5	Unable to observe	

Assessor(s) name(s):	________________________
					________________________
					________________________
Assessor(s) signature(s):	________________________
						________________________
						________________________
				    
Date: _____________