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 try to ensure employees are ready to move to the next level.
• You support the successes of other employees.
• You provide constructive feedback to others.
• You create a work environment that fosters positive feedback to employees.
• You encourage employees through recognition of positive changes in behavior.

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

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 are effective in solving problems.
• You can develop innovative solutions to problems.
• You understand the root causes of problems.
• You are able to solve problems at root cause rather than at symptom level.
• You identify and assess all potential responses to a problem.

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 maintain a state of readiness to address new and changing regulations and procedures.
• You ensure the company meets legal requirements/standards regarding employees.
• You create and maintain necessary regulatory documentation.
• You comply with regulatory requirements for the state.
• You are familiar with EEOC, FLSA, OSHA and ERISA acts/standards.

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 ...

• I interact effectively with people from different cultural backgrounds.
• You understand how your own cultural background can impact the way you communicate and interact with others.
• You recognize and value individual and cultural differences.
• You understand the impact that your culture may have on interactions between individuals.
• You value the opinions of diverse groups and individual.

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.