Planning- 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.

Planning

• Prioritizes plans based on a cost/benefit analysis.
• Encourages others to follow the plan.
• Adjusts and rearranges the schedule to maximize efficiency.
• Ensures staff have the supplies and resources necessary to enact the plan.
• Works in an organized manner

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

Comments:

Self Management

• Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
• Uses patience and self-control in working with customers and associates.
• Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
• Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
• Analyzes interpersonal problems instead of reacting to them.

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

Comments:

Emotional Intelligence

• Able to understand others' points of view.
• Is attentive to emotional cues and interprets others' feelings correctly.
• Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
• Accurately perceives the emotional reactions of others.
• Is able to express themselves clearly.

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

Comments:

Technical

• Is knowledgeable of procedures or systems necessary for the job.
• Willingly shares his/her technical expertise; sought out as resource by others
• Demonstrates mastery of the technical competencies required in his/her work.
• Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
• Willingly shares information and expertise; sought out as resource by others

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

Comments:

Trustworthy

• Works in a way that makes others want to work with her/him.
• Demonstrates congruence between statements and actions.
• Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
• Takes care to maintain confidential information.
• Is a person you can trust.

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.