Self-Management - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

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.

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.

Self Management

What does Self Management mean?
It means that ...

• You do not allow own emotions to interfere with the performance of others.
• You analyze interpersonal problems instead of reacting to them.
• You use patience and self-control in working with customers and associates.
• You step away from a situation to process appropriate response.
• You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.

To what extent does this person exhibit Self Management?
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

Communication Skills

What does Communication Skills mean?
It means that ...

• You convey ideas confidently and succinctly.
• I use polite language and show respect for others' opinions and time.
• You are persuasive and articulate when communicating.
• You deliver clear and concise instructions.
• I communicate clearly and get to the point without unnecessary details.

To what extent does this person exhibit Communication Skills?
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

Punctuality

What does Punctuality mean?
It means that ...

• You start the workday when scheduled.
• You respond to requests for information in a timely manner.
• You invoice clients on a timely basis.
• You avoid making personal phone calls during working hours.
• You maintain an efficient schedule of activities.

To what extent does this person exhibit Punctuality?
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

Quality

What does Quality mean?
It means that ...

• You design effective quality control systems.
• I engage and leads staff in implementation of new quality procedures.
• You make sure cleanliness standards are met to reduce the possibility of contamination.
• I identify appropriate sources of quality standards.
• I successfully implement quality controls within the department.

To what extent does this person exhibit Quality?
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

Coaching

What does Coaching mean?
It means that ...

• You meet regularly with employees to coach them on areas that will enhance your performance
• You develop the skills and capabilities of others.
• You help employees to understand responsibilities, authority, and expectations.
• You coach employees in how to strengthen knowledge and skills to improve work performance.
• You conduct regular performance appraisals and feedback.

To what extent does this person exhibit Coaching?
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.