Developing Others - 360 Degree Feedback Survey Sample #11

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.

Developing Others

What does Developing Others mean?
It means that ...

• You encourage employees through recognition of positive changes in behavior.
• You create opportunities for professional development.
• You provide constructive feedback to others.
• You are open to receiving feedback.
• You create a work environment that fosters positive feedback to employees.

To what extent does this person exhibit Developing Others?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Coaching

What does Coaching mean?
It means that ...

• You conduct regular performance appraisals and feedback.
• You develop the skills and capabilities of others.
• You help employees to maintain high personal standards.
• You meet regularly with employees to coach them on areas that will enhance your performance
• You address employee behavior problems effectively.

To what extent does this person exhibit Coaching?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Problem Solving

What does Problem Solving mean?
It means that ...

• You generate alternative solutions to problems and challenges.
• You are able to balance the needs of different people in a solution to a problem.
• You actively seek the root cause of a problem.
• You can develop innovative solutions to problems.
• You are effective in solving problems.

To what extent does this person exhibit Problem Solving?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Regulatory/Compliance

What does Regulatory/Compliance mean?
It means that ...

• You are aware of federal and local laws affecting employees.
• You are familiar with EEOC, FLSA, OSHA and ERISA acts/standards.
• You review skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
• You follow all safety regulations and procedures.
• You maintain historical records and documents as needed/required.

To what extent does this person exhibit Regulatory/Compliance?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Cultural Awareness

What does Cultural Awareness mean?
It means that ...

• You understand how your own cultural background can impact the way you communicate and interact with others.
• I interact effectively with people from different cultural backgrounds.
• I seek to reduce obstacles in communication that might arise from cultural differences.
• I participate in cultural training sessions/classes.
• I view diversity as a strength, not as an issue.

To what extent does this person exhibit Cultural Awareness?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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