Empowering Others- 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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Thank you for your participation in the survey.

Management Team

Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Supports the decisions of others.
Lets employees make their own decisions.
Establishes goals that allow employees top operate independently in the field.
Views others in the department as valued assets to be trained and employed.
Is confident in the abilities of employees assigned important tasks.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Open to receiving feedback from others.
Deconstructs complex issues into understandable segments.
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
Willing to accept feedback from others.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative and inspirational.
Adds value to the department/organization.
Creates a lot of new ideas.
Develops solutions to challenging problems.
Is creative.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Analyzes interpersonal problems instead of reacting to them.
Consciously controls own negative emotions in order to keep team morale up.
Does not allow own emotions to interfere with the performance of others.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks for ways to improve work processes and procedures.
Looks for ways to expand current job responsibilities.
Analyzes processes to determine areas for improvement.
Looks for ways to expand and learn new job skills.
Promotes training and development opportunities to enhance job performance.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains focus when handling several problems or tasks simultaneously.
Helps guide employees with prioritizing tasks.
Aligns the department's goals with the goals of the organization.
Stays focused even when under pressure and stress.
Maintains self-control when personally criticized.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Determines the impact of specific risks on reputation.
Outlines the risk management framework including responsibilities, description of the process, and guidance on evaluating risk criteria and appropriate risk responses.
Implements strategic risk management in an objective and tactical way.
Create contingency plans.
Develops appropriate strategies to minimize risks.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages individuals to modify their underlying work behaviors that may have contributed to the conflict.
Avoids conflicts over minor issues.
Persuades others to accept personal transformation.
Reframes conflicts as opportunities to innovate and create new solutions to problems.
Helps employees to think through alternative ways to resolve conflict situations.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Impresses upon others the important aspects of [Company].
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Aligns personal vision with global strategies.
Attends training seminars and conferences to increase skills in working with others globally.
Understands and appreciates the perspectives offered by others with different cultural backgrounds.
Builds working relationships with others across cultures.
Creates an environment where individual differences are valued and supported.

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.