Responsibility - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

You can save your progress on partially completed forms by clicking the Save/Still Working button located at the bottom of the page. This allows you to come back at a later time to finish or make any necessary edits to the form. When you return, your previously saved responses will automatically be displayed, allowing you to seamlessly continue where you left off. When you have completed filling out the form and are confident that no further changes are needed, please click the Complete button.

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Responsible

• Responsible for setting the vision of the department.
• Holds herself / himself accountable to goals / objectives
• Is a person you can trust.
• ...takes personal responsibility for results.
• Sets a good example.

If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Action

• Is the first to volunteer for assignments.
• Sets high standards for themselves and others.
• Works quickly when faced with difficult problems.
• Completes challenging projects successfully despite setbacks.
• Fixes problems when they occur.

If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Goals

• Goal Setting
• Understands & contributes to development of strategic goals.
• Conducts timely follow-up; keeps others informed on a need to know basis.
• Achieves established goals.
• Achieves goals.

If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?

Developing Others

• Tries to ensure employees are ready to move to the next level.
• Creates a work environment that fosters positive feedback to employees.
• Provides constructive feedback to others.
• Encourages employees through recognition of positive changes in behavior.
• Supports the successes of other employees.

If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

Strategic Insight

• Develops a strategic vision for the future.
• Creates a mission statement describing the purpose for the organization.
• Observes employees at work to get better insight into the issues they are dealing with.
• Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
• Converses with customers and clients to get a better insight into their personal needs.

If [Participant Name] were to make improvements in Strategic Insight, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.