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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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in implementing new organizational vision and values.
Works cooperatively with others to implement changes.
Supports the Company's efforts to implement changes.
Assists others in understanding changes to the organization.
Able to get department employees to accept new changes.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Rapidly completes tasks and assignments.
Driven to complete assignments on time.
Systematically works to improve the organization
Completes work to a high technical standard
Holds others to high standards of achievement.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Avoids stating unclear or conflicting goals.
Maintains clarity in goals and objectives.
Clearly explains the vision and goals of the company.
Seeks to reduce ambiguity in messaging and documents.
Clarifies problems and their causes to help employees correct them.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates informative guides regarding potential risks and risky behaviors.
Effectively responds to critical situations to reduce potential for losses.
Works within constraints of the organization.
Is aware of process safety management.
Evaluates risks against acceptable risk levels.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates a sense of responsibility and commitment to public trust.
Communicates an understanding of the other person's interests, needs and concerns.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Is a person you can trust.
Takes ownership, delivers on commitments
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops the skills and capabilities of others.
Meets regularly with employees to coach them on areas that will enhance their performance
Addresses employee behavior problems effectively.
Helps employees to maintain high personal standards.
Conducts regular performance appraisals and feedback.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Says "thank you" to show appreciation for work of others.
Is sincerely interested in the suggestions of co-workers
Recognizes individuals for a specific outstanding achievement.
Offers recognition in a timely manner.
Reinforces and rewards employees for accomplishing necessary goals.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Describes and summarizes data.
Understands the costs, profits, markets, and added value of issues.
Understands consumer behaviors and how they may change in the future.
Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
Understands the dynamics of our industry.

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.