Empowering 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.

Empowering Others

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

• I view others in the department as valued assets to be trained and employed.
• I allow for flexibility in the working hours.
• I value the opinions of others.
• I create a culture where employees are given the opportunity to take the initiative and make impactful decisions.
• You give employees the freedom to set their own schedule.

To what extent does this person exhibit Empowering 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

Supervisory Skills

What does Supervisory Skills mean?
It means that ...

• You give employees the ability to complete their tasks as they see fit.
• I provide feedback that is aligned with performance expectations.
• I convey instructions, directives and guidelines to the employees.
• I instruct employees on the safest way to perform tasks.
• I listen to the concerns of employees.

To what extent does this person exhibit Supervisory Skills?
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

Results Oriented

What does Results Oriented mean?
It means that ...

• I measure progress toward the goal.
• You keep track of progress toward the results.
• You exceed performance requirements.
• Completed work exceeds standards.
• I views obstacles as opportunities to improve myself.

To what extent does this person exhibit Results Oriented?
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

Business Acumen

What does Business Acumen mean?
It means that ...

• You understand complex issues and problems.
• I am aware of regulations that impact our business.
• You identify new business opportunities.
• I develop business plans that are forward looking.
• I gather essential customer data to align our products with their expectations.

To what extent does this person exhibit Business Acumen?
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

Integrity

What does Integrity mean?
It means that ...

• You establish relationships of trust, honesty, fairness, and integrity.
• You protect the integrity and confidentiality of information
• You develop trust and confidence from others.
• You maintain strong relationships with others.
• You follow tasks to completion.

To what extent does this person exhibit Integrity?
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.