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
Assigns tasks that are within the skill levels of employees.
Gives employees the resources they need to complete the job.
Avoids micromanaging their employees.
Gives employees the authority to act on their own.
Recognizes that employees may need flexibility in their working hours.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Produces written content that is both succinct and orderly.
Willing to accept feedback from others.
Listens actively & speaks clearly and directly.
Faces the person when speaking or listening to engage in direct communication.
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a lot of new ideas.
Develops solutions to challenging problems.
Inspires creativity in their team.
Is creative and inspirational.
Is creative.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Analyzes interpersonal problems instead of reacting to them.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Consciously controls own negative emotions in order to keep team morale up.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
Analyzes processes to determine areas for improvement.
Looks for ways to improve work processes and procedures.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets appropriate goals for employees.
Makes sure that employees understand how their work relates to organizational goals.
Aligns the department's goals with the goals of the organization.
Excellent at managing time.
Makes sure that employees understand and identify with the team's mission.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Create contingency plans.
Uses data from the purchasing department to anticipate possible supply chain risks.
Effectively manages risk for the department.
Identifies the controls needed.
Bases decisions on patterns found in fluid/changing information.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Addresses concerns about the availability of limited resources.
Is open and honest to avoid misunderstandings.
Strives to ensure that all basic needs are met, resulting in mutual benefits for both parties.
Identifies the root sources of conflict.
Creates an environment where team members work collaboratively rather than compete with one another.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Expresses loyalty and dedication to [Company] in interactions with others.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the use of [Company] products and services.
Attends [Company] gatherings and social events.
Follows existing procedures and processes.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can effectively deliver presentations to international clients.
Communicates effectively on a multi-lingual basis.
Understands how cultures differ and how these differences impact work behavior.
Is able to work with individuals having different backgrounds and cultures.
Builds working relationships with others across cultures.

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.