Coworker Development - 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.

Co-worker Development

• Provides ongoing feedback to co-workers on their development progress
• Sets and clearly communicates expectations, performance goals, and measurements to others
• Gives others development opportunities through project assignments and increased job responsibilities
• Works to identify root causes of performance problems
• Takes immediate action on poor performance

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

Comments:

Emotional Intelligence

• Is able to express themselves clearly.
• Is able to manage their own emotions.
• Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
• Is able to control their own emotions.
• Is attentive to emotional cues and interprets others' feelings correctly.

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

Comments:

Quality

• Analyze what occurred and re-adjusts accordingly when goals are not met.
• Encourages others to produce the highest quality work products.
• Always strives to produce the highest quality work products.
• Holds employees accountable for their quality of work.
• Corrects issues in a timely manner.

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

Comments:

Achievement

• Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
• Follows-up and takes action when goals are not met to ensure better results in the future.
• Completes work to a high technical standard
• Accepts setbacks and challenges as improvement opportunities
• Systematically works to improve the organization

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

Comments:

Trustworthy

• Works in a way that makes others want to work with her/him.
• Communicates an understanding of the other person's interests, needs and concerns.
• Is trustworthy; is someone I can trust.
• Takes ownership, delivers on commitments
• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.

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.