Leadership - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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 you at the conclusion of this assessment to help guide your ongoing professional 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

Leadership	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You give direct, constructive, and actionable feedback.
You sit down regularly with employees to review your job performance.
You are a highly effective supervisor.
You hold others accountable for your actions.
You lead team to set goals, solve problems, and accomplish tasks.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You plan and organize continuously while performing all other responsibilities and activities.
You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
You use a scheduler/planner to keep tasks organized and on time.
You organize tasks for the most efficient order of completion.
You complete multiple tasks simultaneously.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You demonstrate a sense of responsibility and commitment to public trust.
You work in a way that makes others want to work with you.
You are a person others can count on.
You consistently keep commitments.
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are a person others can trust.
You set a good example
You work in a way that makes others want to work with you.
You hold yourself accountable to goals / objectives
You take personal responsibility for results.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You conduct regular performance appraisals and feedback.
You develop the skills and capabilities of others.
You address employee behavior problems effectively.
You help employees to maintain high personal standards.
You meet regularly with employees to coach them on areas that will enhance your performance
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You identify new business opportunities.
You maintain currency with laws, regulations, policies, procedures, trends, and developments.
I am aware of regulations that impact our business.
I understand consumer behaviors and how they may change in the future.
You can effectively interpret and analyze market data.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You analyze unique issues or problems impacting the Company.
You formulate policies and strategies for addressing the Company's important challenges.
You identify potential problems before they become critical incidents.
You create strategies that significantly benefit the Company.
You analyze records and reports to obtain insight into potential issues and trends.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You provide budgeting and accounting support to the Company.
You monitor spending.
You ensure others follow the correct rules and regulations on fiscal matters.
You develop budgets and plans for various programs and initiatives.
You monitor expenses and verify the need for items purchased.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You collaborate with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
You build working relationships with others across cultures.
You engage in problem solving with individuals outside of the country.
You demonstrate working knowledge of global transactions.
You form strong client relationships with international partners.

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.