Trustworthy - 360 Degree Feedback Survey Sample #12

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.

Trustworthy

• Consistently keeps commitments.
• Demonstrates congruence between statements and actions.
• Demonstrates a sense of responsibility and commitment to public trust.
• Is a person you can trust.
• Works in a way that makes others want to work with her/him.

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

Comments:

Leadership

• Recognizes individual and team accomplishments and reward them appropriately.
• Able to influence others.
• Acts decisively in implementing decisions.
• Sets a high level of performance expectations and challenges others to do the same.
• Demonstrates leadership and courage in critical situations.

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

Comments:

Problem Solving

• Able to balance the needs of different people in a solution to a problem.
• Actively seeks the root cause of a problem.
• Effective in solving problems.
• Implements effective solutions to critical problems.
• Works cooperatively with others to solve problems.

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

Comments:

Results Oriented

• Removes bureaucratic barriers to streamline processes.
• Willing to adapt to new procedures to maintain production capacities.
• Has a positive attitude that encourages others to continue supporting the production goals.
• Determined to complete tasks regardless of obstacles that may occur.
• Directs team in prioritizing daily work activities

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

Comments:

Empowering Others

• Values the opinions of others.
• Set clear goals for assignments.
• Enables employees to take on more challenging roles.
• Fosters a sense of ownership and accountability for the process/product.
• Allows the team to take responsibility for the project.

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.