Problem Solving - 360 Degree Feedback Survey Sample #12





360 Feedback Survey

Questionnaires Measuring Problem Solving:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
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.

Competencies Included:
Problem Solving, Action, Performance, Cultural Awareness, Entrepreneurship
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.


Problem Solving

  • Effective in solving problems.
  • Understands the root causes of problems.
  • Works cooperatively with others to solve problems.
  • Actively seeks the root cause of a problem.
  • Makes judgments based upon relevant information.
Needs
Improvement		 Fully
Proficient		 Excels/
Role Model






Click this box to make your rating
Comments:

Action

  • Acts quickly to create innovative products and services.
  • Is the first to volunteer for assignments.
  • Focuses on tasks without being distracted.
  • Overcomes obstacles that may impede progress on a task.
  • Is decisive when making decisions.
Needs
Improvement		 Fully
Proficient		 Excels/
Role Model






Click this box to make your rating
Comments:

Performance

  • Listens and responds to issues and problems
  • Able to organize work.
  • ...Overall Performance
  • Has great overall performance
  • Works effectively in the department.
Needs
Improvement		 Fully
Proficient		 Excels/
Role Model






Click this box to make your rating
Comments:

Cultural Awareness

  • Hires individuals with different cultural backgrounds for the department.
  • Willing to work with employees who have different cultural backgrounds.
  • Respects the views offered by individuals with different cultural backgrounds.
  • Recognizes and values individual and cultural differences.
  • Values the opinions of diverse groups and individual.
Needs
Improvement		 Fully
Proficient		 Excels/
Role Model






Click this box to make your rating
Comments:

Entrepreneurship

  • Encourages risk taking for developing potential business opportunities.
  • Finds unique ways to go around barriers to success.
  • Maintains a high level of energy to respond to demands of the job.
  • Takes the initiative to complete tasks.
  • Able to adapt the department to changing business demands and climate.
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.