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

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Empowering Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Gives employees input into the decision making process.
Values the opinions of others.
Enables employees to take on more challenging roles.
Helps employees advance their skills so that they can have more autonomy.
Creates a culture where employees are recognized and rewarded for taking the initiative and making impactful choices.
Communication Skills	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Writes complete and developmentally-oriented performance appraisals with clear goals, using SMART criteria
Ready to offer feedback, even if it involves tough critiques.
Prepares and delivers presentations.
Effectively engages with everyone from the CEO to external partners.
Coaches others on their written communication skills
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a lot of new ideas.
Is creative and inspirational.
Conceives, implements and evaluates ideas.
Is creative.
Develops solutions to challenging problems.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses patience and self-control in working with customers and associates.
Steps away from a situation to process appropriate response.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Consciously controls own negative emotions in order to keep team morale up.
Analyzes interpersonal problems instead of reacting to them.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks for ways to expand and learn new job skills.
Promotes training and development opportunities to enhance job performance.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Analyzes processes to determine areas for improvement.
Looks for ways to expand current job responsibilities.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets appropriate goals for employees.
Stays focused even when under pressure and stress.
Maintains self-control when personally criticized.
Maintains focus when handling several problems or tasks simultaneously.
Aligns the department's goals with the goals of the organization.
Managing Risk	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Aware of appropriate actions to minimize risks.
Seeks to maintain the long-term viability of the Company through effective risk management.
Determines the proper tools to efficiently manage the risk.
Determines the impact of specific risks on finances.
Determines if the level of risk is tolerable.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Promotes employee engagement to reduce tensions and negativity, creating an environment where conflicts are easily managed.
Identifies the root cause of the problems.
Prepares team members to accept differing view points.
Tries to understand others' point of view before making judgments
Able to settle disputes equitably.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands the use of [Company] products and services.
Impresses upon others the important aspects of [Company].
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.
Understands how decisions impact other business units beyond their immediate department of work group.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Aligns personal vision with global strategies.
Builds working relationships with others across cultures.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Forms strong client relationships with international partners.
Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.

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.