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
Encourages others to obtain necessary skills and training.
Gives employees the opportunity to make their own decisions at work.
Is aware of the skill levels of others.
Demonstrates confidence in the abilities of subordinates.
Set clear goals for assignments.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Deals with difficult situations calmly and confidently.
Is an effective communicator
Presents issues, ideas, and strategy concisely and clearly.
Checks for understanding throughout conversations or group presentations/discussions
Communicates effectively with all levels of the organization.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative and inspirational.
Adds value to the department/organization.
Develops solutions to challenging problems.
Conceives, implements and evaluates ideas.
Inspires creativity in their team.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses patience and self-control in working with customers and associates.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Does not allow own emotions to interfere with the performance of others.
Analyzes interpersonal problems instead of reacting to them.
Steps away from a situation to process appropriate response.
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.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Analyzes processes to determine areas for improvement.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Aligns the department's goals with the goals of the organization.
Sets appropriate goals for employees.
Functions well under stress, deadlines, and/or significant workloads.
Stays focused even when under pressure and stress.
Makes sure that employees understand and identify with the team's mission.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops policies to address risk situations in the workplace.
Offers training to reduce safety incidents in the workplace.
Gathers information regarding potential risks.
Attends risk management seminars and conferences.
Performs a risk analysis as needed.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Clearly expresses expectations to others.
Assists team members by helping them see the other point of view.
Tries to understand others' point of view before making judgments
Discusses conflict situations with supervisor.
Helps employees to think through alternative ways to resolve conflict situations.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Understands the "basics" as to how [Company] functions/operates.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the use of [Company] products and services.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Collaborates with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
Accepts setbacks and challenges in foreign markets as improvement opportunities
Works well with others from different cultural backgrounds.
Considers customers point of view when making decisions.
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.