Delegation - 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

Delegation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Allows subordinates to use their own methods and procedures.
Defines the roles, responsibilities, required actions, and deadlines for team members.
Entrusts subordinates with important tasks.
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Defines goals and objectives for subordinates.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Produces high quality work.
Can be counted on to add value wherever they are involved.
Demonstrates the analytical skills to do their job.
Is planful and organized.
Keeps themselves and others focused on constant improvement.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides ongoing feedback to co-workers on their development progress
Adapts coaching and mentoring approach to meet the style or needs of individuals
Sets and clearly communicates expectations, performance goals, and measurements to others
Gives others development opportunities through project assignments and increased job responsibilities
Works to identify root causes of performance problems
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Readily shares credit and gives others opportunity for visibility.
Is sincerely interested in the suggestions of co-workers
Offers recognition in a timely manner.
Lets employees know when they have done well
Says "thank you" to show appreciation for work of others.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies sources for developing a global competitive advantage for the company.
Identifies and addresses strategic risks impacting operations.
Understands the importance of developing strategic capabilities.
Develops high-level strategic planning models to identify opportunities to improve the company.
Scans both the internal and external environment to identify strategic opportunities to improve the organization.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can work effectively in an environment of uncertainty.
Is comfortable operating in an environment of uncertainty.
Encourages dynamic growth opportunities.
Devotes a certain amount of time and effort to developing new business opportunities.
Excellent at managing relationships with stakeholders.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Determines the amount of materials/supplies needed for the project.
Accomplishes major tasks by breaking them into manageable pieces.
Initiates the planning process by defining the scope of the project.
Creates effective project plans.

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.