Empowering Others - 360 Degree Feedback Survey Sample #10

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.

Empowering Others

• Permits employees to take training to become more independent.
• Values the expertise that others bring to the team.
• Supports the decisions of others even if those decisions may sometimes lead to mistakes.
• Assigns tasks that are within the skill levels of employees.
• Allows employees to take on more responsibilities.

If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Planning

• Determines the amount of materials/supplies needed for the project.
• Establishes and monitors timeframes and timelines.
• Determines the steps required for completion of a task.
• Develops plans to ensure the smooth operation of the supply chain.
• Develops a detailed plan outlining tasks, resources, timelines, and deliverables.

If [Participant Name] were to make improvements in Planning, what are your suggestions for how he/she can improve this?

Negotiation

• Is prepared to walk away if core interests are not met.
• Manages emotions to reduce the impact of negativity.
• Creates a decisive, team-oriented environment; clarifies goals; and outlines a strategic agenda.
• Stays focused and avoids getting sidetracked by less important issues.
• Demonstrates confidence in own position and can influence the other party's perception of proposals being offered.

If [Participant Name] were to make improvements in Negotiation, what are your suggestions for how he/she can improve this?

Adaptability

• Responds quickly to new information.
• Can take on new assignments.
• Adjusts to new plans and procedures.
• Able to adjust to changing environments.
• Develops insights and applies innovative solutions to projects and problems.

If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Quality

• Investigates critical incidents that impact quality.
• Implements appropriate training to maintain high quality standards.
• Presents quality information and data in an easy to understand format.
• Promotes quality improvement practices in the department.
• Competently and accurately analyzes quality measures.

If [Participant Name] were to make improvements in Quality, what are your suggestions for how he/she can improve this?

Overall, please rate the effectiveness of [Participant Name Here].

5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

Strengths


Areas for Development


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