Achievement - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Achievement

• Follows-up and takes action when goals are not met to ensure better results in the future.
• Takes reasonable risks to achieve desired results.
• Completes work to a high technical standard
• Eliminates bureaucratic barriers to streamline processes.
• Met required benchmarks for the position.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Continual Improvement

• Encourages an employee culture of continuous improvement to seek out better ways of doing things.
• Looks for ways to expand and learn new job skills.
• Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
• Looks for ways to expand current job responsibilities.
• Open to the suggestions from others.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Attitude

• Is gracious and professional in their interactions with others.
• Works to eliminate unnecessary work or barriers that get in others' way.
• Contributes to a positive and fun work environment.
• Contributes to a positive work environment.
• Builds open and trusting relationships.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Regulatory/Compliance

• Complies with regulatory requirements for the state.
• Develops a confidential reporting system to enable employees to anonymously report safety violations.
• Implements strategies to ensure compliance.
• Uses compliance reports to evaluate the effectiveness of compliance initiatives identifying areas of risk.
• Offers training to employees to ensure they comply with regulations.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strategic Focus

• Communicates goals and objectives to employees.
• Crafts and executes strategies to advance the company.
• Is effective in using strategic tools such as value chain analysis, business environment analysis, and competitor analysis.
• Identifies and addresses strategic risks impacting operations.
• Strategically focuses efforts to improve operational efficiencies.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.