Empowering Others - 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.

Empowering Others

• Distributes the workload to subordinates.
• Avoids micromanaging their employees.
• Encourages others to obtain necessary skills and training.
• Provides support and resources needed to accomplish goals.
• Allows individuals to be responsible for their decisions.

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

Comments:

Decision Making

• Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
• Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
• Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
• Does not lose sight of the big picture when making decisions
• Exercises good judgment by making sound and informed decisions.

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

Comments:

Juggling Multiple Responsibilities

• Assesses current capabilities before committing to new requests from customers.
• Can multi-task while performing all of their other responsibilities and activities.
• Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
• Bounces back from daily crisis, disappointments and frustrations.
• Plans and organizes continuously while performing all other responsibilities and activities.

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

Comments:

Organizational Fluency

• Able to deal with sensitive issues with tact and professionalism.
• Gets things done through the department.
• Understands departmental policies and procedures.
• Anticipates problems that may affect the department.
• Adept at navigating within the culture of the department.

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

Comments:

Cultural Awareness

• Recognizes and values individual and cultural differences.
• Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
• Values the opinions of diverse groups and individual.
• Seeks out different viewpoints and benefits from different perspectives.
• Respects others regardless of age, race, gender, nationality, or disability.

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.