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

Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You set long and short term goals.
You inform team members how their performance compares to stated goals.
You set and maintain high standards for self and others.
You adjust performance goals as needed to meet the demands of the department/organization.
You provide employees with necessary resources to accomplish your goals.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You strive to meet goals and objectives.
You accept setbacks and challenges as improvement opportunities
You are driven to complete assignments on time.
You set high standards in your performance
You follow-up and take action when goals are not met to ensure better results in the future.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are clear about the roles and duties of team members.
You use appropriate grammar and tense in communications.
You make sure employees understand why they were given certain assignments.
You write clear job descriptions for positions in the organization.
You seek to reduce ambiguity in messaging and documents.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You follow all safety regulations and procedures.
You know who to contact at various regulatory agencies if needed.
You implement regulatory changes in a timely manner.
You explain regulations and procedures to others as required.
You review skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Entrepreneurship	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You encourage dynamic growth opportunities.
You exhibit determination and passion in completion of goals.
You are comfortable operating in an environment of uncertainty.
You devote a certain amount of time and effort to developing new business opportunities.
You take the initiative to complete tasks.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I can initiate the planning process by defining the scope of the project.
I determine the steps required for completion of a task.
I anticipate the impacts of strategic plans.
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
I set the appropriate sequence of tasks to ensure completion of the project.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You apply knowledge of overseas markets.
You analyze global issues/problems that are having a large impact on the Company.
You respect individual differences.
You exemplify the skills of a global worker.
You cooperate with others on a global scale.

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.