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.

Responsible

• Holds herself / himself accountable to goals / objectives
• Sets a good example.
• Is a person you can trust.
• Acts as a resource without removing individual responsibility.
• Sets high personal standards of performance.

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

Action

• Drives and mobilizes others progress toward goals.
• Takes the initiative and does not wait for the situation to change.
• Prepares equipment at the start of the shift.
• Takes action to respond to dissatisfied customer.
• Conducts critical-incident review immediately after the event.

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

Goals

• Makes sure that team members have a clear idea of our group's goals.
• Sets high expectations and goals; encourages others to support the organization.
• Conducts timely follow-up; keeps others informed on a need to know basis.
• Understands & contributes to development of strategic goals.
• Establishes and documents goals and objectives.

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

Developing Others

• Supports the successes of other employees.
• Creates opportunities for professional development.
• Develops employees by offering and encouraging them to take on new or additional responsibilities.
• Creates a work environment that fosters positive feedback to employees.
• Tries to ensure employees are ready to move to the next level.

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

Strategic Insight

• Works with others to develop insights into the resources and actions required to produce desired results.
• Meets with customers to gain insight into their core needs and how best to serve them.
• Creates a vision for the organization based on insights gathered from other companies in the industry.
• Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
• Anticipates business cycles and trends and makes adjustments in a timely manner.

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.