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

Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assists others in understanding changes to the organization.
Supports the Company's efforts to implement changes.
Works cooperatively with others to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Addresses organizational and departmental resistance to changes.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses established goals and performance measures to keep track of performance.
Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.
Is results oriented.
Works at a quick pace to complete a high volume of work.
Completes work promptly and efficiently.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Clarifies problems and their causes to help employees correct them.
Seeks to reduce ambiguity in messaging and documents.
Checks details thoroughly.
Avoids stating unclear or conflicting goals.
Uses appropriate grammar and tense in communications.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is aware of the financial implications of certain risks.
Implements changes to reduce the chances of critical incidents in the future.
Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
Develops appropriate strategies to minimize risks.
Performs a risk analysis as needed.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds and maintains the trust of others.
Demonstrates congruence between statements and actions.
Delivers on promises made.
Communicates an understanding of the other person's interests, needs and concerns.
Consistently keeps commitments.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides clear, motivating, and constructive feedback.
Addresses employee behavior problems effectively.
Develops the skills and capabilities of others.
Helps employees to understand responsibilities, authority, and expectations.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes team members who offer a significant contribution to a project.
Reinforces and rewards employees for accomplishing necessary goals.
Says "thank you" to show appreciation for work of others.
Makes people around them feel appreciated and valued.
Recognizes individuals for a specific outstanding achievement.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Exhibits behavior that is consistent with the vision, mission, and core values of the organization
Applies the knowledge of work processes to influence the achievement of business goals
Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
Considers impact of actions on other areas of the organization.
Able to align resources to meet the business needs of the company.

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.