Others- 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

Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Consistently demonstrates ability and willingness to trust others.
Respects the opinions of other employees.
Works effectively with people from other departments.
Helpful
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks for ways to expand current job responsibilities.
Analyzes processes to determine areas for improvement.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Looks for ways to improve work processes and procedures.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands how their own cultural background can impact the way they communicate and interact with others.
Shows respect in daily interactions
Is responsive to individuals from other cultures.
Understands how implicit biases can affect decisions, communication and productivity.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets and maintains high standards for self and others.
Clearly articulates the performance requirements for the position.
Addresses performance issues as soon as possible.
Holds the team accountable for meeting objectives.
Quality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains detailed instructions to ensure consistency and quality in the production line.
Influences others to achieve high quality standards.
Implements appropriate training to maintain high quality standards.
Creates a culture of quality standards in the workplace.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Eliminates tasks that are unimportant for the job.
Focuses time on the tasks that yield the highest value.
Effectively uses subordinates to help get more work done by the department.
Bundles different tasks together if they can be done at the same time.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willing to do whatever it takes-not afraid to have to put in extra effort.
Able to focus on a task even when working alone.
Coordinates all department activities into a cohesive team effort.
Encourages commitment in others to obtain results.
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willingly shares information and expertise; sought out as resource by others
Knows how to produce high quality products/work.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Is knowledgeable of procedures or systems necessary for the job.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures the company is in compliance with all laws regarding the production and transportation of product.
Reviews documentation and procedures manuals to ensure regulatory compliance.
Maintains a state of readiness to address new and changing regulations and procedures.
Provides documents and reports as needed to maintain compliance with laws.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Delegates the task of implementing the vision to subordinates.
Behaves in a way that is consistent with business values & code of conduct
Creates a common vision for others.
Charts a bold course for the department's evolution.

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

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.