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 set specific, measurable, and challenging goals.
You are a highly effective supervisor.
You act decisively in implementing decisions.
You are able to align manpower, design work, an allocate tasks to achieve goals.
You demonstrate leadership and courage in critical situations.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
You observe, analyze, and respond to merchandise needs while serving customers and accomplishing operational tasks.
You ensure that assignments are prioritized according to the needs of the department/company.
You spend the most time and effort on critical tasks first.
You keep track of multiple assignments and deadlines.
Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You deliver on promises made.
You communicate an understanding of the other person's interests, needs and concerns.
You work in a way that makes others want to work with you.
You are a person others can count on.
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You work in a way that makes others want to work with you.
You take personal responsibility for results.
You set a good example
You are responsible for setting the vision of the department.
You set high personal standards of performance.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop the skills and capabilities of others.
You help employees to maintain high personal standards.
You help employees to understand responsibilities, authority, and expectations.
You coach employees in how to strengthen knowledge and skills to improve work performance.
You provide clear, motivating, and constructive feedback.
Business Acumen	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You ask the 'right' questions to size up or evaluate situations.
You understand complex issues and problems.
You exhibit behavior that is consistent with the vision, mission, and core values of the organization
You are able to align resources to meet the business needs of the company.
You apply the knowledge of work processes to influence the achievement of business goals
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You anticipate business cycles and trends and makes adjustments in a timely manner.
You communicate vision for the department and company.
You identify potential problems before they become critical incidents.
You implement long-term solutions to problems.
You understand the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You monitor spending.
You develop budgets and plans for various programs and initiatives.
You keep excellent records for financial transparency.
You develop of the department's annual budget.
You monitor expenses and verify the need for items purchased.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
You communicate effectively on a multi-lingual basis.
You accept setbacks and challenges in foreign markets as improvement opportunities
You build working relationships with others across cultures.
You volunteer for experiences and assignments abroad.

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.