Responsibility - 360 Degree Feedback Survey Sample #11

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.

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.

Responsible

What does Responsible mean?
It means that ...

• You set a good example
• You set a good example.
• You complete assigned work tasks.
• You are responsible for setting the vision of the department.
• You take personal responsibility for results.

To what extent does this person exhibit Responsible?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Excellence

What does Excellence mean?
It means that ...

• You take a lot of pride in your work.
• You produce high quality work.
• You keep yourself and others focused on constant improvement.
• You demonstrate the analytical skills to do your job.
• You can be counted on to add value wherever you are involved.

To what extent does this person exhibit Excellence?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Continual Learning

What does Continual Learning mean?
It means that ...

• You are open to new ideas and concepts.
• You grasp new ideas, concepts, technical, or business knowledge.
• You build on your strengths while addressing your weaknesses.
• You improve on your skill sets.
• You pursue self-improvement through continual learning.

To what extent does this person exhibit Continual Learning?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Delegation

What does Delegation mean?
It means that ...

• You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
• You set clear and reasonable expectations for others and follow through on their progress.
• You delegate authority and responsibility to subordinates and holds them accountable for your actions.
• You tell subordinates what to do, not how to do it.
• You assign tasks to create learning opportunities for the employees.

To what extent does this person exhibit Delegation?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Global Perspective

What does Global Perspective mean?
It means that ...

• You volunteer for experiences and assignments abroad.
• You work well with others from different cultural backgrounds.
• You understand and appreciate the perspectives offered by others with different cultural backgrounds.
• You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
• You understand how cultures differ and how these differences impact work behavior.

To what extent does this person exhibit Global Perspective?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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