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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Thank you for your participation in the survey.

Management Team

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Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Does things without being told.
Initiates the development of new products.
Takes corrective action to rectify issues.
Prepares for unexpected contingencies.
Confronts problems immediately without supervisor instructions.
Quickly comes to the aid of those who may need help.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effective in dealing with ambiguous and challenging situations.
Develops plans for following through on the changes.
Adopts changes to set and example for others to follow.
Supports new initiatives for organizational changes to improve effectiveness.
Able to get department employees to accept new changes.
Inspires others to accept changes.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides constructive feedback to others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Tries to ensure employees are ready to move to the next level.
Assesses employees' developmental needs.
Creates opportunities for professional development.
Encourages employees through recognition of positive changes in behavior.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps excellent records for financial transparency.
Develops budgets and plans for various programs and initiatives.
Ensures others follow the correct rules and regulations on fiscal matters.
Monitors spending.
Effective in using Company's resources.
Provides budgeting and accounting support to the Company.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Directs team efforts towards key elements of the vision.
Assigns the responsibility of implementing the vision to the team, ensuring they have clear guidance, adequate resources, and the necessary authority.
Plans a roadmap for the department's growth and expansion.
Aligns subordinates' work with the vision's critical priorities.
Is able to diagnose issues and problems and to create a vision for their solutions.
Facilitates employees' adoption of the organization vision.

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.