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
Protects the integrity and confidentiality of information
Accepts responsibility for mistakes.
Fosters a high standard of ethics and integrity.
Follows tasks to completion.
Demonstrates sincerity in actions with others.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is open minded and curious about learning new skills.
Is open to feedback from others.
Takes initiative for own learning and development.
Constantly enhances product knowledge through experimentation and play.
Demonstrates through personal behavior the commitment to high standards of performance.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adds value to the department/organization.
Creates a lot of new ideas.
Develops solutions to challenging problems.
Is creative.
Conceives, implements and evaluates ideas.
Feedback	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Actively seeks feedback from others.
Is easy to approach with ideas and opinions.
Considers other's opinion and suggestions.
Accepts the views of others.
Open to the suggestions of others.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets appropriate goals for employees.
Stays focused even when under pressure and stress.
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand and identify with the team's mission.
Functions well under stress, deadlines, and/or significant workloads.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to organize work.
Communicates goals and objectives to employees.
Consistently provides me with timely feedback for improving my performance.
Sets long-term and short-term goals.
Organizes and schedules events, activities, and resources.
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
Takes immediate action on poor performance
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Works to identify root causes of performance problems
Negotiation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Knows the BATNA (Best Alternative to a Negotiated Agreement) and is prepared to walk away if core interests are not met.
Clearly communicates boundaries and the reasons behind them.
Creates a constructive atmosphere, building a positive relationship for cooperative negotiations.
Uses the motivations of each party to identify mutually advantageous solutions.
Establishes good working relationships with others.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adjusts strategic plans based on insights gathered from different points of view.
Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
Creates strategies that significantly benefit the Company.
Creates values statement to ensure all employees are working under the same guiding principles.
Develops a plan and strategy for each functional area within the mission statement.

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.