Adaptability - 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.

Adaptability

• Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
• Works effectively with various personalities of team members.
• Adjusts to new plans and procedures.
• Learns from personal experiences and/or mistakes.
• Is aware of changes in the environment.

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

Comments:

Integrity

• Protects the integrity and confidentiality of information
• Follows tasks to completion.
• Maintains strong relationships with others.
• Fosters an environment built upon trust.
• Establishes relationships of trust, honesty, fairness, and integrity.

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

Comments:

Cultural Awareness

• Is sensitive to the similarities and differences that exist between cultures.
• Actively listens to other employees' stories about their culture.
• Hires individuals with different cultural backgrounds for the department.
• Avoids referring to stereotypes about others from different cultures.
• Seeks to reduce obstacles in communication that might arise from cultural differences.

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

Comments:

Administrative Skill

• Strong organizational skills to keep the workspace and department in order
• Has strong technical/computer skills.
• High attention to detail.
• Implements and uses performance measures.
• Accurately implements contract provisions.

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

Comments:

Results Oriented

• Has a strong drive to complete goals despite obstacles that may arise.
• Sets the objectives for the team.
• Encourages employees to give 100% to achieving high results.
• Stays focused on solving problems and getting work done.
• Determined to complete tasks regardless of obstacles that may occur.

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.