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.

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

Delegation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Allows employees to decide how they wish to complete the tasks.
Tells subordinates what to do, not how to do it.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Entrusts subordinates with important tasks.
Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes a lot of pride in their work.
Keeps themselves and others focused on constant improvement.
Demonstrates the analytical skills to do their job.
Can be counted on to add value wherever they are involved.
Produces high quality work.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
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
Takes immediate action on poor performance
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Lets employees know when they have done well
Is sincerely interested in the suggestions of co-workers
Finds opportunities to recognize others.
Compliments other people when they do good work
Readily shares credit and gives others opportunity for visibility.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands & contributes to development of strategic goals.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Communicates goals and objectives to employees.
Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains a high level of energy to respond to demands of the job.
Understands the processes and various stages of business development.
Balances risks and rewards when making decisions.
Has a strategic awareness on how to promote the organization.
Excellent at managing relationships with stakeholders.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes plans and follows through.
Establishes and monitors timeframes and timelines.
Develops proper plans to ensure seamless flow of materials through logistics.
Develops good plans used for logistics.
Creates a timeline for events and monitors progress.

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.