360 Degree Feedback Sample 18

Rater: [Your Name]
You are providing feedback to: [Participant Name]

Instructions

You have been asked to evaluate yourself as part of a 360-degree developmental evaluation process. Other employees will also provide you with feedback. In this manner, you will be provided with a comprehensive, multi-perspective view of your performance. The end goal is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

Please provide feedback using the form below. If you are not able to respond to an item, leave it blank and go on to the next item. You do not have to complete entire questionnaire in one sitting. To save your data, press the SUBMIT button at the bottom of the form. You can re-access the survey questionnaire later by clicking on the link provided to you in the email message you received. You are able to return to the survey and enter/edit data as often as needed during the data collection period (_____ ^th - _____^th).

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Job Skills

Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Ensures client commitments and requirements are met or exceeded
Interacts with clients to define roles, expectations, and responsibilities
Looks for opportunities that have a positive impact on Clients
Obtains feedback to ensure client needs are being met
Promotes, implements, maintains and enhances relationships with clients
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accepts accountability for results
Can be counted on to do what they say they are going to do
Develops goals and establishes objective measures of success
Holds team accountable to meeting goals
Keeps their word and does what they say they will do
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accepts setbacks and challenges as improvement opportunities
Accomplishes goals on schedule and under budget
Demonstrates a well-organized and timely approach to achieve desired results
Sets high standards in their performance
Systematically works to improve the organization
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Coordinates all department activities into a cohesive team effort
Willing to do whatever it takes-not afraid to have to put in extra effort
Can be counted on to add value wherever they are involved
Demonstrates the functional or technical skills necessary to do their job
Takes a lot of pride in their work
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Aware of his/her own skills and abilities
Focuses attention on treating the causes of problems rather than simply addressing the symptoms
Makes decisions that are based on available facts, existing constraints, and probable outcomes
Seeks input from key people who should be involved in, or will be affected by, decisions
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Builds relationships across boundaries and with key stakeholders by developing informal and formal networks
Creates a culture that fosters and values collaboration
Partners with people from other work units to improve overall performance
Promotes a team spirit within and outside department; partners with other groups
Shares pertinent information with all members of the team
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Allows subordinates to use their own methods and procedures
Delegates authority and responsibility to subordinates and holds them accountable for their actions
Tells subordinates what to do, not how to do it
Encourages employees to solve problems on their own
Solicits input from others to make informed decisions
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Communicates goals and objectives to employees
Analyzes the best practices and lessons learned from other organizations
Understands & contributes to development of strategic goals
Analyzes global issues/problems that are having a large impact the Company
Solicits and engages diverse groups in organizational processes
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Communicates with others how they contribute to and support the Company's mission
Demonstrates leadership and courage in critical situations
Gives direct, constructive, and actionable feedback
Holds others accountable for their actions
Motivates others to work together toward common objectives
Recognizes and rewards employees for their accomplishments
Sets clear goals and objectives for subordinates
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Developing Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses employees' developmental needs
Creates opportunities for professional development
Facilitates employee training when implementing new programs or systems
Helps to coach other employees
Recognizes and celebrates accomplishments of others
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes personal responsibility for results
Holds herself / himself accountable to goals / objectives
Sets a good example
Does what they say they are going to do
Takes ownership and responsibility for future direction of organization
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Communicates an understanding of the other person's interests, needs and concerns
Is a person you can trust
Conducts all dealings in an honest and upfront manner
Does what was promised
Establishes relationships of trust, honesty, fairness, and integrity
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to work with individuals at all levels of the Company
Demonstrates willingness to work with others
Expresses ideas in an appropriate manner to overcome resistance, complaints, and frustration from others
Listens to others, withholding judgment, and comes across as open to all viewpoints
Provides resources to enable individuals to develop themselves
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Cultural Awareness	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to understand others' points of view
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems
Addresses the unique interests, needs, and concerns of employees
Seeks out different viewpoints and benefits from different perspectives
Values the opinions of diverse groups and individuals
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Investigates the root causes of problems
Looks for ways to improve work processes and procedures
Open to the suggestions from others
Perseus learning that will enhance job performance
Keeps current with new technology
If you were to make improvements in the area listed above, which item do you think should be emphasized most over the next year in order to improve their performance.
Improvement needed in number:
Please offer suggestions on how this can be improved.

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Open-Ended Comments

Considering your comments, please answer the following:

Your greatest strengths as demonstrated in this past year
Advice or suggestions about what you could consider doing differently to be even more successful in your role?

Are there any final comments you would like to add before concluding this 360-Feedback survey.

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