Flexibility - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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 you at the conclusion of this assessment to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Flexibility	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I foster an inclusive learning environment where everyone feels supported, ultimately leading to stronger team cohesion and increased productivity.
I am flexible in effectively handling changes in production volumes.
You are willing to try new approaches to solving problems if the current solution isn't working.
You implement changes as a result of having listened to employees
I accommodate the needs of employees when requests for time off are made.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You step away from a situation to process appropriate response.
You consciously control own negative emotions in order to keep team morale up.
You analyze interpersonal problems instead of reacting to them.
You do not allow own emotions to interfere with the performance of others.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You work toward achieving established goals and objectives.
You effectively organize resources and plans
You set long-term and short-term goals.
You are able to organize work.
You organize and schedules events, activities, and resources.
Collaboration	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I collaborate across departmental boundaries and finds common ground with a wide range of stakeholders.
I contribute expertise, insights, and resources to accelerate solutions to problems.
I develop networks and builds alliances across departments.
You include all stakeholders in the decision making process.
You encourage open communication to support a collaborative environment.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You consistently keep commitments.
You take care to maintain confidential information.
You work in a way that makes others want to work with you.
You are trustworthy; is someone that can be trusted.
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I make plans to handle unforeseen events that could impact the achievement of strategic goals.
I identify ways in which the company is better able to meet the customers' needs than rivals.
You turn strategic priorities into action plans.
You are able to identify internal strengths and weaknesses and the opportunities and threats that impact the company.
You evaluate and review the implementation of the strategic plan to ensure achievement of the objectives.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I understand what equipment will be needed for the project.
I accurately estimate the duration of tasks.
I identify resource requirements that may impact the development of the 5-year plan.
You set the appropriate sequence of tasks to efficiently achieve the goal.
You establish a course of action for self and others to accomplish specific goals.

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.