Adaptability - 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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Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Responsive to the needs of others.
Adapts quickly to new situations.
Adjusts priorities to changing business goals.
Adjusts plans to meet the needs of new constraints.
Embraces change and fosters an open-minded environment.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Accepts the views of others.
Seeks feedback to enhance performance.
Asks others for their ideas and opinions.
Open to the suggestions of others.
Looks to others for input.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Confronts significant problems directly to reduce their impact on the schedule.
Proactively addresses crucial matters.
Reacts promptly to inquiries from customers/clients.
Encourages colleagues to spend more time on work related activities.
Effectively uses subordinates to help get more work done by the department.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates a sense of responsibility and commitment to public trust.
Consistently keeps commitments.
Takes ownership, delivers on commitments
Is a person you can trust.
Is trustworthy; is someone I can trust.
Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Shares credit for accomplishments with team members
Makes decisions that positively impact team performance.
Comes across as a reliable, committed team member
Builds relationships across boundaries and with key stakeholders by developing informal and formal networks.
Supports open communication between team members.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies strengths that competitors would have trouble imitating.
Effective in strategy formulation and execution.
Develops a strategic vision for the future.
Able to identify internal strengths and weaknesses and the opportunities and threats that impact the company.
Makes strategic decisions to optimize the returns on capital investments.

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

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.