Problem Solving - 360 Degree Feedback Survey Sample #9

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.

Problem Solving	Definite Strength	Meets Standards	Needs Development	N/A
Ability to solve problems at root cause rather than at symptom level.
Finds creative ways to get things done with limited resources.
Makes judgments based upon relevant information.
Is a good problem solver and decision maker
Generates alternative solutions to problems and challenges.
Goals	Definite Strength	Meets Standards	Needs Development	N/A
Makes sure that I have a clear idea of our group's goals.
Achieves established goals.
Conducts timely follow-up; keeps others informed on a need to know basis.
Achieves goals.
Makes sure that team members have a clear idea of our group's goals.
Technology Use/Management	Definite Strength	Meets Standards	Needs Development	N/A
Applies complex rules and regulations to maintain optimal system performance.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Supports employee training and development initiatives regarding implementation of technology.
Understands and is committed to implementing new technologies.
Supports technical training and development of employees.
Integrity	Definite Strength	Meets Standards	Needs Development	N/A
Accepts responsibility for mistakes.
Does what was promised.
Demonstrates sincerity in actions with others.
Protects the integrity and confidentiality of information
Demonstrates honesty and truthfulness at all times.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
Seeks opportunities for professional development.
Encourages employees to take courses relevant to their job.
Keep themselves up-to-date of technical/professional issues
Contributing fully to the extent of their skills
Seeks opportunities for continuous learning.
Emotional Intelligence	Definite Strength	Meets Standards	Needs Development	N/A
Is able to manage their own emotions.
Is able to express themselves clearly.
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Accurately perceives the emotional reactions of others.
Safety	Definite Strength	Meets Standards	Needs Development	N/A
Ensures compliance with safety regulations.
Develops a sustainable safety culture.
Develops a strong safety culture.
Is aware of OSHA safety guidelines.
Identifies and addresses safety needs.
Co-worker Development	Definite Strength	Meets Standards	Needs Development	N/A
Works to identify root causes of performance problems
Provides ongoing feedback to co-workers on their development progress
Gives others development opportunities through project assignments and increased job responsibilities
Sets and clearly communicates expectations, performance goals, and measurements to others
Takes immediate action on poor performance
Negotiation	Definite Strength	Meets Standards	Needs Development	N/A
Leverages relationships with others to achieve goals.
Able to adapt to changing situations.
Able to influence others to accept certain positions.
Actively listens to conversations to be able to recall important details later.
Changes communication styles to meet the listener's needs.
Others	Definite Strength	Meets Standards	Needs Development	N/A
...treats others with respect and dignity.
Able to see issues from others' perspectives.
Includes others in the decision making processes.
Is able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Vision	Definite Strength	Meets Standards	Needs Development	N/A
Communicates the vision and strategy of [Company]
Clearly articulates a vision for his/her work and inspires others to support it
Communicates a vision of where the Company needs to be in the future.
Works to support the strategy of [Company]
Develops action plans to align his/her work with the goals of the organization

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

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

    
    
57. Strengths
    
    
    
58. Areas for Development
    
    
    
59. Please give any final comments or suggestions for [Participant Name Here]'s assessment.