Coaching- 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.

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

Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Helps employees to understand responsibilities, authority, and expectations.
Helps employees to maintain high personal standards.
Provides clear, motivating, and constructive feedback.
Addresses employee behavior problems effectively.
Develops the skills and capabilities of others.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes responsibility for results.
Creates a consistent process for prioritizing work.
Is someone you can trust.
Can be counted on to do what they say they are going to do.
Keeps supervisor informed of recent events.
Emotional Intelligence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Accurately perceives the emotional reactions of others.
Able to understand others' points of view.
Is attentive to emotional cues and interprets others' feelings correctly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to manage their own emotions.
Analytical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Asks the "right" questions to size up or evaluate situations.
Identifies problems and issues needing resolution.
Identifies the root cause of a problem.
Balances risks and costs with the rewards and probabilities of success when decisions.
Uses appropriate techniques to solve problems.
Decision Making	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Outlines the parameters influencing the decision making process.
Considers the ethical implications of decisions.
Recognizes and generates innovative solutions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Learns from previous bad decisions and rarely repeats them.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes work promptly and efficiently.
Works at a quick pace to complete a high volume of work.
Uses established goals and performance measures to keep track of performance.
Allocates resources as needed to accomplish organizational goals.
Inspires others to work with a sense of urgency.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates ideas and facts clearly and effectively in writing.
Is clear about goals that need to be achieved.
Provides a clear vision for the future.
Seeks to reduce ambiguity in messaging and documents.
Makes sure employees understand why they were given certain assignments.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a risk profile for projects and teams.
Works within constraints of the organization.
Recognizes that small changes may snowball into major events.
Offers training to reduce safety incidents in the workplace.
Creates a risk management strategy for the department.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Supports and encourages relationships that are created by diverse team members.
Partners with peers to obtain influence within the Company.
Collaborates with others to accomplish goals and objectives.
Creates value within the Company by building networks.
Builds alliances between departments and teams.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Offers recognition in a timely manner.
Recognizes the abilities and skills of self and others
Readily shares credit and gives others opportunity for visibility.
Recognizes individuals for a specific outstanding achievement.
Reinforces and rewards employees for accomplishing necessary goals.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates strategies that significantly benefit the Company.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Analyzes unique issues or problems impacting the Company.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Formulates policies and strategies for addressing the Company's important challenges.

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

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

    
    
57. Strengths
    
    
    
58. Areas for Development
    
    
    
59. Please give any final comments or suggestions for [Participant Name Here]'s assessment.