Initiative - 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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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Will continue to work on a problem even in the face of obstacles.
Looks for opportunities to move projects forward.
Takes action to establish clear and concise deadlines for tasks to be completed.
Acts with urgency when time is of the essence.
Addresses small problems before they become big ones.
Initiates projects that have an impact on the department.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in dealing with ambiguous and challenging situations.
Develops a strategy for implementing changes.
Assists others in understanding changes to the organization.
Inspires others to accept changes.
Is an inspiration for others to accept the recent changes.
Adopts changes to set and example for others to follow.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Supports the successes of other employees.
Encourages employees through recognition of positive changes in behavior.
Sets performance objectives for subordinates that encourages development opportunities.
Creates opportunities for professional development.
Is open to receiving feedback.
Provides constructive feedback to others.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors spending.
Provides budgeting and accounting support to the Company.
Keeps excellent records for financial transparency.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Develops of the department's annual budget.
Develops budgets and plans for various programs and initiatives.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Crafts a compelling roadmap for the department's future.
Provides a detailed schedule that specifies key milestones and deadlines, guiding the organization step-by-step towards achieving its long-term goals and overall vision.
Envisions and articulates a clear path for the department's growth over the next year.
Designs a forward-thinking strategy to achieve the department's growth goals.
Committed to turning the strategic vision into reality by meticulously planning, coordinating, and overseeing the implementation of an action plan.
Establishes an inspiring and strategic vision for the department.

31. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.