Achievement - 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.

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Thank you for your participation in the survey.

Management Team

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Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Establishes stretch goals to advance skills and output.
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Sets challenging goals for the department.
Inspires others to work with a sense of urgency.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Clarifies problems and their causes to help employees correct them.
Provides a clear vision for the future.
Seeks to reduce ambiguity in messaging and documents.
Clearly explains responsibilities to individuals.
Makes sure goals and objectives are clearly and thoroughly explained and understood.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps track of changes in legislation affecting regulatory compliance.
Creates and maintains necessary regulatory documentation.
Submits complete applications for necessary certifications.
Offers training on various subjects to help ensure employees are aware of regulations.
Creates a standardized response protocol for responding to compliance related issues.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Treats clients with courtesy and respect.
Understands the needs of the client.
Documents client interactions.
Manages client accounts with high degree of competence.
Is above average in addressing the needs of the clients.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assigns tasks and responsibilities to develop skills of others.
Creates a work environment that fosters positive feedback to employees.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Supports the successes of other employees.
Assesses employees' developmental needs.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Consistently demonstrates ability and willingness to trust others.
Works effectively with people from other departments.
Works across boundaries within the organization.
Respects the opinions of other employees.
Treats others with respect and dignity.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks and utilizes mentors to help guide professional development.
Maintains a high level of energy to respond to demands of the job.
Can work effectively in an environment of uncertainty.
Excellent at managing relationships with stakeholders.
Balances risks and rewards when making decisions.

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.