Creativity - 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

Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adds value to the department/organization.
Creates a lot of new ideas.
Develops solutions to challenging problems.
Conceives, implements and evaluates ideas.
Inspires creativity in their team.
Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Conveys a sense of urgency about addressing problems and opportunities
Completes a large volume of work.
Encourages risk taking and experimentation to improve performance
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Completes work on time
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks clarification to avoid misunderstandings.
Is aware of the similarities and differences among and between cultural groups.
Shows respect in daily interactions
Values the opinions of diverse groups and individual.
Understands the impact that our culture may have on interactions between individuals.
Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in performing his/her job.
Sets a high standard for job performance.
Has great overall performance
Works effectively in the department.
Shown significant improvement in job performance.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Focuses on achieving important goals.
Plans the best course of action to achieve the goal.
Promptly and efficiently completes assigned tasks.
Helps others when free-time is available.
Determines the objectives for the project.
Interpersonal Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willing to overlook personal differences and focus on completing the task at hand.
Pays close attention to what is being communicated verbally and nonverbally.
Assists employees that need help.
Uses knowledge and charisma rather than position, power, or coercion to influence others
Recognizes when others do a good job.
Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Empowers employees to structure their work hours to maximize their productivity.
Gives employees opportunities to demonstrate their skills.
Creates opportunities for employees to exercise their independence.
Lets employees complete tasks according to their methods.
Values the opinions of others.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Builds alliances with others in the company.
Creates an environment that supports information exchange.
Forms strong relationships with customers.
Strengthens the contacts with other departments.
Facilitates communication with others in the company.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is sincerely interested in the suggestions of co-workers
Recognizes the abilities and skills of self and others
Recognizes team members who offer a significant contribution to a project.
Makes people around them feel appreciated and valued.
Offers recognition in a timely manner.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is comfortable operating in an environment of uncertainty.
Able to adapt the department to changing business demands and climate.
Finds unique ways to go around barriers to success.
Seeks and utilizes mentors to help guide professional development.
Takes the initiative to complete tasks.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.