Commitment to Result - 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

Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to focus on a task even when working alone.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Encourages commitment in others to obtain results.
Committed to the team.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Gives others development opportunities through project assignments and increased job responsibilities
Takes immediate action on poor performance
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Works to identify root causes of performance problems
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates a willingness to participate in continuing education courses.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Takes initiative for own learning and development.
Enhances value to the company through additional training and development.
Holds self and associates accountable for goal achievement.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Forms working relationships with employees from other departments.
Helpful
Includes others in the decision making processes.
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Influences the attitudes and behaviors of subordinates to match the department's vision.
Develops strategies that align with the organization's collective vision.
Leads employees in new directions.
Cultivates an environment that embodies the department's vision.
Detects problems and creates solutions.

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.