Leadership - 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.

Leadership

• Takes ownership and accountability for results
• Able to align manpower, design work, an allocate tasks to achieve goals.
• Motivates others to reach and exceed organizational goals and objectives.
• Sets specific, measurable, and challenging goals.
• Able to organize the work of others.

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

Comments:

Establishing Focus/Direction

• Sets appropriate goals for employees.
• Maintains focus when handling several problems or tasks simultaneously.
• Aligns the department's goals with the goals of the organization.
• Helps guide employees with prioritizing tasks.
• Excellent at managing time.

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

Comments:

Persuasion and Influence

• Ensures stakeholders are involved in the decision making process.
• Seeks to obtain consensus or compromise.
• Persuades others to consider alternative points of view.
• Attempts to persuade others rather than simply control them.
• Has excellent influencing/negotiating skills.

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

Comments:

Safety

• Participates in safety training when available.
• Is aware of OSHA safety guidelines.
• Creates accurate and effective measures of safety.
• Points out behaviors in others that may be unsafe.
• Ensures compliance with safety regulations.

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

Comments:

Global Perspective

• Collaborates with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
• Sets the example for team on importance of cultural awareness.
• Communicates effectively on a multi-lingual basis.
• Cooperates with others on a global scale.
• Works well with others from different cultural backgrounds.

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.