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.

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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.
Follows tasks to completion.
Fosters a high standard of ethics and integrity.
Protects the integrity and confidentiality of information
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Holds self and associates accountable for goal achievement.
Enhances value to the company through additional training and development.
Embraces new technology and procedures.
Is open to feedback from others.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Inspires creativity in their team.
Conceives, implements and evaluates ideas.
Is creative.
Adds value to the department/organization.
Develops solutions to challenging problems.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is easy to approach with ideas and opinions.
Actively seeks feedback from others.
Accepts the views of others.
Looks to others for input.
Open to the suggestions of others.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains focus when handling several problems or tasks simultaneously.
Functions well under stress, deadlines, and/or significant workloads.
Makes sure that employees understand how their work relates to organizational goals.
Excellent at managing time.
Helps guide employees with prioritizing tasks.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages me to take on greater responsibility.
Organizes and schedules events, activities, and resources.
Able to organize work.
Assures [Company] principles are understood, employed & pursued.
Sets long-term and short-term goals.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works to identify root causes of performance problems
Takes immediate action on poor performance
Provides ongoing feedback to co-workers on their development progress
Gives others development opportunities through project assignments and increased job responsibilities
Sets and clearly communicates expectations, performance goals, and measurements to others
Negotiation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Justifies viewpoints using strong and credible data.
A proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
Fosters a robust, collaborative setting; sets clear expectations; and introduces an agenda that matches priorities.
Assesses the validity and relevance of each piece of information, considering the context and source.
Actively listens to conversations to be able to recall important details later.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a vision for the organization based on insights gathered from other companies in the industry.
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Communicates with employees to find out their needs.
Develops a strategic vision for the future.
Creates values statement to ensure all employees are working under the same guiding principles.

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.