Objectives - 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.

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

Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ability to establish realistic goals.
Communicates goals and objectives to employees.
Effectively organizes resources and plans
Consistently provides me with timely feedback for improving my performance.
Works toward achieving established goals and objectives.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets specific and measurable goals for others and follows through to completion.
Adjusts performance goals as needed to meet the demands of the department/organization.
Establishes indicators to measure levels of performance.
Continuously measures performance and provides feedback to employees regularly.
Provides employees with necessary resources to accomplish their goals.
Analytical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Prioritizes various actions to be taken when solving a problem.
Selects the appropriate techniques for analysis.
Analyzes data and information from several sources and arrives at logical conclusions.
Implements data validation techniques and methods.
Identifies problems and issues needing resolution.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies and assesses all potential responses to a problem.
Implements effective solutions to critical problems.
Ability to develop innovative solutions to problems.
Is a good problem solver and decision maker
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Maximizes the use of new technology to deliver products and services.
Supports employee training and development initiatives regarding implementation of technology.
Adopts the implementation of new technology into the workplace.
Understands and is committed to implementing new technologies.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Says "thank you" to show appreciation for work of others.
Compliments other people when they do good work
Is sincerely interested in the suggestions of co-workers
Reinforces and rewards employees for accomplishing necessary goals.
Lets employees know when they have done well

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

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

    
    
32. Strengths
    
    
    
33. Areas for Development
    
    
    
34. Please give any final comments or suggestions for [Participant Name Here]'s assessment.