Change Management - 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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Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to get department employees to accept new changes.
Works cooperatively with others to implement changes.
Addresses organizational and departmental resistance to changes.
Able to get team members to change their attitudes.
Is an inspiration for others to accept the recent changes.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completed training on the new equipment.
Completes work promptly and efficiently.
Sets challenging goals for the department.
Increased production by 20 percent.
Helps others to improve or meet standards of performance.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Checks details thoroughly.
Communicates with clarity and efficiency.
Is clear about goals that need to be achieved.
Communicates ideas and facts clearly and effectively in writing.
Writes clear job descriptions for positions in the organization.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Determines the amount of deviation from the plan that will be tolerated.
Understands that risk may represent a threat or an opportunity.
Provides support to managers involved in the risk management process.
Determines the impact of specific risks on reputation.
Improves process safety where possible.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes ownership, delivers on commitments
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Is trustworthy; is someone I can trust.
Builds and maintains the trust of others.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Helps employees to maintain high personal standards.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Develops the skills and capabilities of others.
Helps employees to understand responsibilities, authority, and expectations.
Conducts regular performance appraisals and feedback.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Finds opportunities to recognize others.
Says "thank you" to show appreciation for work of others.
Reinforces and rewards employees for accomplishing necessary goals.
Is sincerely interested in the suggestions of co-workers
Readily shares credit and gives others opportunity for visibility.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Calculates return on investment (ROI) for various business projects.
Able to get department employees to accept new business workflows.
Describes and summarizes data.
Collects valuable customer insights to ensure our services meet their needs.
Able to decipher complex data making it easier to generate new insights.

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

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.