Accountability - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

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 Closing Comments section. 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.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes full responsibility for project outcomes.
Takes responsibility for errors in the production line.
Acts like an owner when they make decisions.
Shows up for work on time.
Keeps supervisor informed of recent events.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Effective in solving problems.
Understands the root causes of problems.
Actively seeks the root cause of a problem.
Finds creative ways to get things done with limited resources.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative and inspirational.
Inspires creativity in their team.
Creates a lot of new ideas.
Develops solutions to challenging problems.
Conceives, implements and evaluates ideas.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes use of talents of others to help achieve a high level of performance.
Increased production by 20 percent.
Sets challenging goals.
Takes reasonable risks to achieve desired results.
Allocates resources as needed to accomplish organizational goals.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates and distributes code of ethics and code of conduct.
Observes, monitors and coordinates compliance activities.
Maintains a state of readiness to address new and changing regulations and procedures.
Complies with regulatory requirements for the state.
Develops compliance reports in accordance with federal and industry regulations.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Puts client's needs first.
Able to handle difficult clients.
Maintains strong relationships with clients.
Is committed to resolving client issues in a positive way.
Thoroughly understands the needs of the client.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors company performance and makes adjustments to the strategic plan as needed.
Looks for opportunities to enhance contributions to the bottom line.
Creates a mission statement describing the purpose for the organization.
Understands the importance of developing strategic capabilities.
Identifies business strategies to strengthen competitive capabilities.

36. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.