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
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Is open to change and adjusts plans when needed.
Successfully adapts working style as directed by new management.
Able to work effectively with new people and new teams.
Learns from personal experiences and/or mistakes.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Employs feedback judiciously to foster professional growth, maintaining a focus on ethical and constructive use.
Demonstrates a firm commitment to continuous learning and self-improvement.
Is easy to approach with ideas and opinions.
Is open to receiving insights from others about their strengths and areas needing development.
Actively seeks and values feedback from a variety of sources, including peers, supervisors, and external stakeholders.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is always on time for meetings.
Schedules work based on peak productivity periods to enhance focus and output.
Schedules deep-focus time for complex problem-solving and strategic planning.
Keeps and maintains a To-Do list.
Effectively delegates tasks to maximize the use of time.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates an understanding of the other person's interests, needs and concerns.
Is a person you can trust.
Consistently keeps commitments.
Is trustworthy; is someone I can trust.
Demonstrates congruence between statements and actions.
Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willingly share their technical expertise
Finds opportunities to recognize and reward team members.
Works well with other team members.
Regularly attends team meetings.
Makes decisions that positively impact team performance.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a SWOT matrix to help analyze data.
Assigns individuals the responsibility of keeping track of progress toward achieving milestones.
Supports changes being recommended from senior management.
Aligns cross-functional teams to the strategic plan.
Makes strategic changes to stay ahead of changes in the business environment.

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.