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

• Is open to new ideas and innovations.
• Is aware of changes in the environment.
• Able to work effectively with new people and new teams.
• Is flexible when dealing with changes.
• Is aware of changes to team personnel.

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

Comments:

Integrity

• Fosters an environment built upon trust.
• Demonstrates honesty and truthfulness at all times.
• Follows tasks to completion.
• Fosters a high standard of ethics and integrity.
• Demonstrates sincerity in actions with others.

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

Comments:

Cultural Awareness

• Supports and mentors others that may have different cultural backgrounds.
• Hires individuals with different cultural backgrounds for the department.
• Shows respect in daily interactions
• Avoids referring to stereotypes about others from different cultures.
• Engages with individuals that have different cultural backgrounds.

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

Comments:

Administrative Skill

• Enthusiastic about taking on challenging projects.
• High attention to detail.
• Implements and uses performance measures.
• Has strong technical/computer skills.
• Strong organizational skills to keep the workspace and department in order

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

Comments:

Results Oriented

• Inspires and motivates co-workers to be productive and energetic at work
• Works toward achievement of goals even when confronted with obstacles.
• Provides clear expectations for employees.
• Explains the "whys" behind organizational objectives
• Stays focused on meeting the needs of customers.

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.