Performance Review – 360 Feedback Form

Reviewing 7/1/2014-6/30/2015

Date: / / 2015

This form is being completed about: / This form is being turned in to: / This form is being completed by:
Employee: / Supervisor / Rater:
Print Name / Print Name / Print Name
Job Title / Job Title / Job Title
5 / Excellent:Routinely exceeds expectations, goes above and beyond standards.
4 / Very Good: Often exceeds expectations; a job very well done.
3 / Good: Meets expectations, a job well done.
2 / Needs Improvement: Does not consistently meet expectations; must improve.
1 / Unsatisfactory: Meets very few of the expectations; improvement seems unlikely.

Performance FactorsPerformance factors, or competencies, measure how well the job is being performed. It considers the way in which the employee has generally worked at his/her job this past year; it is not about rating the actual achievements. Most factors apply to most jobs. Please take the opportunity to comment on observed behaviors specific to the employee being reviewed.

Performance Factors – Definition of each factor. Rating Comments
Job Knowledge:The level of technical and professional understanding of the current job; how well fundamental aspects of the job are grasped and applied. / 1 / 2 / 3 / 4 / 5
Innovation:The degree to which creativity is applied in solving problems; ability to identify and pursue new approaches and appropriate risk-taking. / 1 / 2 / 3 / 4 / 5
Acceptance of Responsibilities: The individual makes challenging commitments and together with the supervisor holds him- or herself accountable; shows follow-through and completion. / 1 / 2 / 3 / 4 / 5
Professional Communication: The ability to express ideas, verbally and in written formats, in a clear and precise manner; the ability to listen professionally. / 1 / 2 / 3 / 4 / 5
Interpersonal Skills:Colleagues and others are kept informed; the ability to build and maintain healthy relationships through communicating with others. / 1 / 2 / 3 / 4 / 5
Creating a Learning Environment: Measures the individual’s commitment to sharing new concepts with others; a proactive approach to sharing knowledge. / 1 / 2 / 3 / 4 / 5
Adaptability and Flexibility: Measures openness to change, ability to adapt to changing job and organizational requirements, and ability to maintain patience, confidence and composure under pressure. / 1 / 2 / 3 / 4 / 5
Initiative:How well problems are anticipated, opportunities are seized, and action is taken; the degree to which attempts are made to achieve results. / 1 / 2 / 3 / 4 / 5
Efficiency: How well resources – skills, time, budgets, and the time of others – are managed. The degree to which resources are prioritized and applied. / 1 / 2 / 3 / 4 / 5
Collaboration: The extent to which colleagues and projects are embraced with a participative spirit. The individual both initiates and responds to collaborative opportunities within and/or outside the organization. / 1 / 2 / 3 / 4 / 5
Outcomes & Impact: The individual advances the agency mission, goals, and strategic plan through timely and accurate reporting on successes, qualitative and quantitative outcomes, and lessons learned. / 1 / 2 / 3 / 4 / 5
Demonstration of Core Values:The extent to which actions and behaviors reflect MLC core values to:
1) promote the power of learning; 2) maximize human potential; 3) energize communities; 4) foster inclusion; 5) advance equality and justice; 6) lead the way. / 1 / 2 / 3 / 4 / 5
[For Supervisors] Program/Department Management:Provides leadership for work plan development. Seeks opportunities that will strengthen program/department. Successfully manages departmental and project goals and budgets. Connects effectively with constituents and partners within and outside the agency. / 1 / 2 / 3 / 4 / 5
[For Supervisors] Staff Development and Supervision: Creates a high-functioning team that is supportive, collaborative and effectively navigates challenges and opportunities. Routinely checks in with staff on performance and encourages professional development. Communicates up, down and laterally to ensure staff are informed and supported in doing their work. / 1 / 2 / 3 / 4 / 5
Other Comments