Managing Performance - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

You are going to be participating in a 360-Degree assessment. As part of this process you will need to complete the self-assessment questionnaire form below.

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

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Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I measure performance using standard production quotas.
I monitor performance on a regular basis.
I implement remediation plans as needed.
You routinely hold audits of performance on a weekly or monthly basis.
You implement remediation plans with follow up after 3 months.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You complete work to given time frame and to budget
You accept setbacks and challenges as improvement opportunities
You are driven to complete assignments on time.
You take immediate action of projects that fall behind schedule.
I was able to increase production by 20 percent.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You provide a clear vision for the future.
You clearly explains responsibilities to individuals.
You avoid stating unclear or conflicting goals.
You adjust communication methods to the needs of the audience.
You clearly explain the vision and goals of the company.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I follow up on any unresolved compliance issues.
You keep track of changes in legislation affecting regulatory compliance.
I prepare and present annual reports as required.
I coordinate with legal counsel investigating any instances of misconduct.
I review anti-retaliation policies to ensure compliance with government standards.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You maintain a high level of energy to respond to demands of the job.
You are comfortable operating in an environment of uncertainty.
You encourage risk taking for developing potential business opportunities.
You exhibit determination and passion in completion of goals.
You balance risks and rewards when making decisions.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You create to-do lists to make sure nothing is missed.
I have plans to handle unexpected events.
You assess the potential impact of changes to the strategic plan.
You set up and monitor timeframes and plans
You are open to input from others into the plan for the project.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You demonstrate working knowledge of global transactions.
You exemplify the skills of a global worker.
You are able to work with others from different cultures and countries.
You volunteer for experiences and assignments abroad.
You consider customers point of view when making decisions.

36. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.