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
Sets clear and reasonable expectations for others and follows through on their progress.
Allows subordinates to use their own methods and procedures.
Entrusts subordinates with important tasks.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Assigns tasks to create learning opportunities for the employees.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.
Keeps themselves and others focused on constant improvement.
Is planful and organized.
Can be counted on to add value wherever they are involved.
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
Works to identify root causes of performance problems
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Takes immediate action on poor performance
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is sincerely interested in the suggestions of co-workers
Recognizes team members who offer a significant contribution to a project.
Says "thank you" to show appreciation for work of others.
Lets employees know when they have done well
Reinforces and rewards employees for accomplishing necessary goals.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops a strategic plan for adapting the organization to better respond to external changes in the marketplace.
Identifies areas where return on investment can be improved.
Aligns projects to the strategic goals of the company.
Sets strategic objectives to be achieved.
Analyzes the environment to develop strategies to achieve competitive advantage in the marketplace.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can work effectively in an environment of uncertainty.
Devotes a certain amount of time and effort to developing new business opportunities.
Excellent at managing relationships with stakeholders.
Encourages risk taking for developing potential business opportunities.
Seeks and utilizes mentors to help guide professional development.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Determines the allocation of funds based on plans for future development.
Is able to clearly articulate the plan for the department/district.
Schedules staff based on seasonal needs.
Makes strategic and tactical decisions to guide the logistics process.
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.