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360-Degree Performance Appraisal Form

(1) This document contains a 360-degree performance appraisal form for evaluating an employee's performance over the last 12 months. (2) The form includes ratings for various criteria such as communication, responsibility, problem solving, and customer service. (3) Ratings are accompanied by spaces for the evaluator to provide specific examples and reasons for the ratings.

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Cristine Sauter
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348 views3 pages

360-Degree Performance Appraisal Form

(1) This document contains a 360-degree performance appraisal form for evaluating an employee's performance over the last 12 months. (2) The form includes ratings for various criteria such as communication, responsibility, problem solving, and customer service. (3) Ratings are accompanied by spaces for the evaluator to provide specific examples and reasons for the ratings.

Uploaded by

Cristine Sauter
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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SAMPLE: 360-DEGREE PERFORMANCE APPRAISAL FORM

EMPLOYEE ASSESSMENT QUESTIONNAIRE

Employee Name:_________________________________________

Evaluator Name and Position: _______________________________

Ratings:

Ratings should be based on the last 12 months of observations.


Outstanding—a standard rarely achieved by others and substantially exceeding job requirements.
Good—a standard fully meeting all requirements of the job and often exceeding them.
Satisfactory—a standard fully meeting all requirements of the job.
Unsatisfactory—many of the basic requirements of the job are often not met.

Reasons for Ratings:


Provide specific examples of conduct that support the rating.
Note: If you have not observed an item, simply write “Not observed” in the blank for a rating.

Communications
Listens to others, communicates well (written and verbal), providing effective and timely communication to others.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Responsibility
Accepts responsibility for decisions, whatever the outcomes are. Looks for and evaluates alternatives. Solicits and
encourages ideas from subordinates, peers, superiors, customers, vendors, etc. Acknowledges originators of ideas. Seeks
greater responsibility, but not to a fault. Requires little supervision. Recommends actions.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Problem Solving
Analyzes and identifies problems, secures relevant information, relates data from different sources, identifies possible
causes of problems, and takes corrective action. Suggests possible solutions, alternatives, and new methods. Focuses on
“how to.” Develops alternate courses of action and makes decisions based on logical assumptions and factual information.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Assertiveness (not Aggressiveness)


Is direct, honest, behaves appropriately, and does not step on others in the process. Expresses thoughts in a way that is
direct, honest, and appropriate, and does not offend others. Is a decision maker. Requires little supervision. Is self-
confident.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Risk Taking
Thinks independently. Takes calculated risks when appropriate. Makes difficult commitments. Acts as needed in
supervisor’s absence. Makes good decisions with limited facts when necessary.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Internal Customer Service/Satisfaction


Consults with internal resources as appropriate. Identifies the internal customers and their goals and needs. Seeks to
satisfy those goals and needs. Is sensitive to how others are affected by what the department does or decisions that are
made.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

External Customer Service/Satisfaction


Available when needed. Identifies and satisfies customers’ goals and needs.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Vendor Satisfaction
Communicates with vendors in a timely and professional manner. Offers practical, acceptable solutions. Anticipates
problems, then identifies and implements steps to avoid them. Focuses on “how to,” rather than shifting blame.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________
Planning and Organizing
Prioritizes, assigns, and completes tasks effectively. Anticipates problems and carries out actions to avoid them. Actively
influences events to achieve goals. Uses resources effectively. Allocates decision-making and other responsibilities
appropriately.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Teamwork
Patient, calm, and empathetic with others. Works with others for the common good of all and tolerates differences.
Open-minded. Seeks to understand others and seeks to be understood.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Strives to Set Common Objectives


Schedules and conducts timely and effective meetings that increase information sharing, problem solving, and mutual
respect. Is helpful and supportive in daily contacts.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

Safety
Knows safety standards and policies. Recognizes the importance of safety and takes timely action to correct unsafe
conditions.
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

External Events and Extenuating Circumstances


Did any factors beyond the individual’s control affect the individual’s performance (e.g., weather, natural disaster,
strikes, the economy, change in vendor, economic changes, other departments)?
Rating: ________________________________________________________________
Reasons for rating:
______________________________________________________________________
______________________________________________________________________

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