Attitude - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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 you at the conclusion of this assessment to help guide your ongoing professional 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

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Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You treat all people fairly and with respect.
You show by your actions that you trust in the positive intentions of others.
You are gracious and professional in your interactions with others.
You contribute to a positive work environment.
You work to eliminate unnecessary work or barriers that get in others' way.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are an effective problem-solver
You gather input from various team members helps to ensure that the problem is fully understood from all angles, reducing the risk of oversight.
You establish clear, measurable goals that the action plan aims to achieve.
I use tools like Gantt charts and resource calendars can help visualize and manage solutions.
You establish realistic budgets consistent with strategic objectives
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You willingly share your technical expertise; sought out as resource by others
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You demonstrate mastery of the technical competencies required in your work.
You are knowledgeable of procedures or systems necessary for the job.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop safety guidelines for the department.
You mitigate hazards and safety issues that arise.
You identify predictable hazards in the workplace.
You develop a strong safety culture.
You encourage others to attend safety training.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You act as a resource without removing individual responsibility.
You set a good example
You are responsible for setting the vision of the department.
You are a person others can trust.
You work in a way that makes others want to work with you.
Teamwork	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You let team members know when they have done well.
I work well with other team members.
You show respect for other team members.
You take the time to actively listen to other team member's perspectives.
I express appreciation for the work of other team members.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You make people around them feel appreciated and valued.
You recognize team members who offer a significant contribution to a project.
You let employees know when they have done well
You find opportunities to recognize others.
You offer recognition in a timely manner.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You monitor expenses and verify the need for items purchased.
You ensure others follow the correct rules and regulations on fiscal matters.
You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
You keep excellent records for financial transparency.
You monitor spending.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assign the right tasks to the right people and holds them accountable.
I can adjust and rearrange the schedule to maximize efficiency.
I can create a timeline for events and monitors progress.
I can determine the amount of materials/supplies needed for the project.
You are able to clearly articulate the plan for the department/district.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.