Continual Learning - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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 you at the conclusion of this assessment to help guide your ongoing professional 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

Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You set relevant learning objectives and goals.
You build on your strengths while addressing your weaknesses.
You share best practices with others and learn from others.
I view setbacks as opportunities to learn from.
You grasp new ideas, concepts, technical, or business knowledge.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
You do not allow own emotions to interfere with the performance of others.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You use patience and self-control in working with customers and associates.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You encourage employees to take courses relevant to their job.
You allow employees to fully participate in employee training and professional development.
You seek opportunities for professional development.
You seek opportunities for continuous learning.
You quickly acquire and apply new knowledge and skills when needed
Punctuality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You avoid making personal phone calls during working hours.
You start meetings on time.
You arrive to meetings on time.
You maintain an efficient schedule of activities.
You respond to requests for information in a timely manner.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You deliver on commitments made to clients.
I understand what resources are needed to meet client needs.
You create customized solutions for the client.
I keep the client informed of all progress.
I exceed expectations of the clients.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are aware of the skill levels of employees and assign tasks that are at the appropriate skill level.
You express confidence in the abilities of others.
You encourage employees to solve problems on your own.
You distribute the workload to subordinates.
You give employees autonomy to complete tasks on their own.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You find opportunities to recognize others.
You readily share credit and gives others opportunity for visibility.
You recognize the abilities and skills of self and others
You are sincerely interested in the suggestions of co-workers
You make people around them feel appreciated and valued.

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

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

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.