Responsibility - 360 Degree Feedback Survey Sample #12

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.

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Responsible

• Works in a way that makes others want to work with her/him.
• Sets high personal standards of performance.
• Responsible for setting the vision of the department.
• Sets a good example
• Acts as a resource without removing individual responsibility.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Management

• Strategically optimizes resources to improve efficiency.
• Modifies project plans and priorities when faced with unexpected challenges or shifting requirements.
• Leads the team through visible, disciplined execution that motivates others to maximize their own contributions.
• Clearly communicates the scope of authority employees have when making decisions.
• Maintains an open-door policy to be available to answer questions and provide guidance to employees.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Innovation

• Fosters a culture of creativity and curiosity by actively listening to and considering new ideas and opportunities.
• Creates innovative solutions to critical problems facing the Company.
• Creates a framework to support innovation.
• Challenges existing work processes/products to enhance value.
• Optimizes the innovation process by incorporating feedback and lessons learned from previous experiences.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Technology Use/Management

• Uses technology in decision making and problem solving.
• Understands and is committed to implementing new technologies.
• Applies complex rules and regulations to maintain optimal system performance.
• Proficient in the use of technical systems and processes.
• Supports employee training and development initiatives regarding implementation of technology.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Company

• Promotes CompanyName as a high quality company.
• Attends [Company] gatherings and social events.
• Reinforces the company's mission and values in everyday decisions and communications.
• Provides opportunities for skill development and career advancement within the company.
• Aligns departmental strategies with the company's long-term vision and objectives.

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.