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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Thank you for your participation in the survey.

Management Team

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Integrity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Protects the integrity and confidentiality of information
Demonstrates honesty and truthfulness at all times.
Demonstrates sincerity in actions with others.
Fosters an environment built upon trust.
Develops trust and confidence from others.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Holds self and associates accountable for goal achievement.
Is open minded and curious about learning new skills.
Demonstrates a willingness to participate in continuing education courses.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Creates an environment that supports personal development and exploration.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is creative.
Is creative and inspirational.
Inspires creativity in their team.
Adds value to the department/organization.
Develops solutions to challenging problems.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks feedback to enhance performance.
Asks others for their ideas and opinions.
Is easy to approach with ideas and opinions.
Actively seeks feedback from others.
Accepts the views of others.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains focus when handling several problems or tasks simultaneously.
Sets appropriate goals for employees.
Maintains self-control when personally criticized.
Makes sure that employees understand and identify with the team's mission.
Makes sure that employees understand how their work relates to organizational goals.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works toward achieving established goals and objectives.
Ability to establish realistic goals.
Establishes goals and objectives.
Organizes and schedules events, activities, and resources.
Able to organize work.
Co-worker Development	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works to identify root causes of performance problems
Sets and clearly communicates expectations, performance goals, and measurements to others
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Takes immediate action on poor performance
Negotiation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is prepared to walk away if core interests are not met.
Ensures a thorough understanding of key issues and priorities.
Identifies goals and objectives desired as well as the strengths and weaknesses currently possessed.
Identifies verbal and nonverbal cues to help interpret actions and messages.
Maintains control over emotions to ensure a constructive environment.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
Develops a strategic vision for the future.
Inspires employees to adopt the strategic plan.
Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
Meets with customers to gain insight into their core needs and how best to serve them.

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.