Clarity - 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

Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Attends to the important details of a job or task.
Writes clear job descriptions for positions in the organization.
Makes sure employees understand why they were given certain assignments.
Uses appropriate grammar and tense in communications.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to develop, justify and present a budget.
Completes reports on-time.
Takes responsibility for decisions.
High attention to detail.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Determines which tasks need to be completed urgently.
Organizes work responsibilities for maximum efficiency.
Continues working on the most important tasks until they are completed.
Is committed to finishing the most important tasks.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages employees to give 100% to achieving high results.
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Completes work on time.
Directs team in prioritizing daily work activities
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Applies complex rules and regulations to maintain optimal system performance.
Maximizes the use of new technology to deliver products and services.
Supports employee training and development initiatives regarding implementation of technology.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps themselves and others focused on constant improvement.
Can be counted on to add value wherever they are involved.
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops a strong safety culture.
Points out behaviors in others that may be unsafe.
Performs work safely.
Commits adequate resources toward safety measures.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes ownership, delivers on commitments
Is trustworthy; is someone I can trust.
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates congruence between statements and actions.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds herself / himself accountable to goals / objectives
Behavior is ethical and honest.
Sets a good example
Acts as a resource without removing individual responsibility.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assigns tasks and responsibilities to develop skills of others.
Is open to receiving feedback.
Encourages employees through recognition of positive changes in behavior.
Creates opportunities for professional development.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops plans to ensure the smooth operation of the supply chain.
Creates to-do lists to make sure nothing is missed.
Assesses the risks of various strategic plans.
Prioritizes tasks based on urgency/need.

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

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

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