Customer Focus- 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.

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

Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adapts to changing customer needs.
Maintains strong relationships with customers.
Persistent in solving customer issues.
Understands the needs of the customer.
Develops strong customer relationships.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains eye contact to foster direct communication.
Can effectively deliver presentations.
Maintains an open-door policy to be available for answers and guidance when needed.
Ready to offer feedback, even if it involves tough critiques.
Adapts language and terminology to meet the needs of the audience.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Interacts effectively with people from different cultural backgrounds.
Shows respect in daily interactions
Is curious and willing to ask questions about the cultural differences in the workplace.
Is aware of differences in how individuals from other cultures greet one another.
Seeks opportunities to learn about the other cultural backgrounds of colleagues.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes sure that employees understand and identify with the team's mission.
Maintains focus when handling several problems or tasks simultaneously.
Stays focused even when under pressure and stress.
Aligns the department's goals with the goals of the organization.
Helps guide employees with prioritizing tasks.
Supervisory Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Instructs employees on the safest way to perform tasks.
Identifies and maximizes opportunities for continuing education for employees.
Intervenes immediately if disciplinary action is warranted.
Maintains good working relationships with employees.
Works well with the team members.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies and assesses all potential responses to a problem.
Understands the root causes of problems.
Skilled at quickly diagnosing issues, identifying root causes, and developing and implementing effective solutions in the workplace.
Finds creative ways to get things done with limited resources.
Ability to solve problems at root cause rather than at symptom level.
Goals	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Achieves goals.
Establishes and documents goals and objectives.
Conducts timely follow-up; keeps others informed on a need to know basis.
Achieves established goals.
Makes sure that I have a clear idea of our group's goals.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes multiple tasks simultaneously.
Ensures that assignments are prioritized according to the needs of the department/company.
Assigns tasks based on skills of team members.
Switches attention to more urgent tasks when necessary.
Is aware of the deadlines for specific tasks/assignments.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Understands and is committed to implementing new technologies.
Supports employee training and development initiatives regarding implementation of technology.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assures [Company] principles are understood, employed & pursued.
Encourages me to take on greater responsibility.
Consistently provides me with timely feedback for improving my performance.
Organizes and schedules events, activities, and resources.
Effectively organizes resources and plans

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.