Integrity - 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.

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

Integrity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains strong relationships with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Develops trust and confidence from others.
Demonstrates sincerity in actions with others.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds self and associates accountable for goal achievement.
Creates an environment that supports personal development and exploration.
Takes initiative for own learning and development.
Demonstrates a willingness to participate in continuing education courses.
Will participate in training classes even if offered outside of normal working hours.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative and inspirational.
Is creative.
Inspires creativity in their team.
Creates a lot of new ideas.
Adds value to the department/organization.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is visible and approachable.
Is easy to approach with ideas and opinions.
Considers other's opinion and suggestions.
Open to the suggestions of others.
Seeks feedback to enhance performance.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes sure that employees understand and identify with the team's mission.
Excellent at managing time.
Sets appropriate goals for employees.
Maintains focus when handling several problems or tasks simultaneously.
Helps guide employees with prioritizing tasks.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Consistently provides me with timely feedback for improving my performance.
Works toward achieving established goals and objectives.
Organizes and schedules events, activities, and resources.
Communicates goals and objectives to employees.
Able to organize work.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adapts coaching and mentoring approach to meet the style or needs of individuals
Provides ongoing feedback to co-workers on their development progress
Works to identify root causes of performance problems
Takes immediate action on poor performance
Sets and clearly communicates expectations, performance goals, and measurements to others
Negotiation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Establishes clear communications to avoid misunderstandings.
Changes communication styles to meet the listener's needs.
Is flexible in responses.
Identifies verbal and nonverbal cues to help interpret actions and messages.
Stays calm and focuses on the core issues to be discussed.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Anticipates business cycles and trends and makes adjustments in a timely manner.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Analyzes records and reports to obtain insight into potential issues and trends.
Creates strategies that significantly benefit the Company.
Formulates policies and strategies for addressing the Company's important challenges.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.