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

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Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You pursue learning that will enhance job performance.
You improve on your skill sets.
You take charge of your training and skills enhancement.
I view setbacks as opportunities to learn from.
You take the initiative to learn new skills.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
You consciously control own negative emotions in order to keep team morale up.
You use patience and self-control in working with customers and associates.
You step away from a situation to process appropriate response.
You do not allow own emotions to interfere with the performance of others.
Professional Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are contributing fully to the extent of your skills
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You keep yourself up-to-date of technical/professional issues
You seek opportunities for continuous learning.
You allow employees to fully participate in employee training and professional development.
Punctuality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You respond to requests for information in a timely manner.
You start the workday when scheduled.
You arrive to meetings on time.
You start meetings on time.
You maintain an efficient schedule of activities.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I respond to feedback from clients.
You adapt to changes proposed by the client.
You provide excellent service to clients.
You use client feedback to help improve products and services.
Your activities reflect a strong focus on the client relationship.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I allow employees to take ownership of their work.
You support the decisions of others.
You avoid micromanaging your employees.
You are aware of the skill levels of employees and assign tasks that are at the appropriate skill level.
You create opportunities for employees to exercise their independence.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You award effective non-monetary reward such as time off, keepsakes, or other awards.
You are an effective advocate for recognition programs in the department/organization.
You use internal communication tools or recognition platforms to instantly acknowledge achievements.
I ensure that above average performance is followed up with recognition.
You integrate recognition programs into larger employee development initiatives.

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.