Commitment - 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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Commitment	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds self and others accountable for staying focused on agreed deliverables.
Exhibits commitment by challenging excuses and rationalizations, keeping the focus on responsibility and results.
Prioritizes organizational values and aligns personal effort with the mission, even when it requires sacrifice.
Empowers employees with resources and training, enabling them to commit to meet objectives.
Encourages alignment between individual effort and organizational priorities.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets and clearly communicates expectations, performance goals, and measurements to others
Gives others development opportunities through project assignments and increased job responsibilities
Works to identify root causes of performance problems
Takes immediate action on poor performance
Provides ongoing feedback to co-workers on their development progress
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Exhibits willingness to upgrade skills through additional training and education.
Takes initiative for own learning and development.
Stays up-to-date on emerging technologies.
Will participate in training classes even if offered outside of normal working hours.
Is open minded and curious about learning new skills.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works across boundaries within the organization.
Forms working relationships with employees from other departments.
Treats others with respect and dignity.
Consistently demonstrates ability and willingness to trust others.
Is able to see issues from others' perspectives.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes and rewards behaviors that are consistent with the company's vision.
Ensures that messaging about the vision remains clear, stable, and free from contradiction.
Encourages employees to embrace the departmental vision.
Influences the attitudes and behaviors of subordinates to match the department's vision.
Concentrates employees' tasks on essential parts of the vision.

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

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

    
    
27. Strengths
    
    
    
28. Areas for Development
    
    
    
29. Please give any final comments or suggestions for [Participant Name Here]'s assessment.