Bias for Action - 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.

Bias for Action

• Displays high energy and enthusiasm on consistent basis.
• Completes a large volume of work.
• Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
• Coach others to foster an environment which can adapt quickly and willingly to rapid change.
• Seeks and utilizes opportunities for continuous learning and self-development.

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

Comments:

Cultural Awareness

• Understands how implicit biases can affect decisions, communication and productivity.
• Is sensitive to the similarities and differences that exist between cultures.
• Fosters a diverse workforce free from discrimination and harassment.
• Supports and mentors others that may have different cultural backgrounds.
• Is curious and willing to ask questions about the cultural differences in the workplace.

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

Comments:

Innovation

• Encourages open communication to ensure that all proposals are considered.
• Analyzes current procedures and identifies opportunities for improvement.
• Creates a safe environment for idea-sharing.
• Creates improved methods or solutions for meeting goals and objectives.
• Searches for opportunities and innovative ways to improve the organization.

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

Comments:

Co-worker Development

• Gives others development opportunities through project assignments and increased job responsibilities
• Takes immediate action on poor performance
• Adapts coaching and mentoring approach to meet the style or needs of individuals
• Works to identify root causes of performance problems
• Provides ongoing feedback to co-workers on their development progress

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

Comments:

Planning

• Assesses the risks of various strategic plans.
• Ensures staff are held accountable for following the department plan.
• Establishes and monitors timeframes and timelines.
• Creates a timeline for events and monitors progress.
• Determines the allocation of funds based on plans for future development.

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.