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
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
Constructively receives criticism and suggestions from others.
Able to see issues from others' perspectives.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks for ways to improve work processes and procedures.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is open and honest in communications with individuals from other cultures.
Fosters a diverse workforce free from discrimination and harassment.
Functions effectively within various cultural contexts.
Effective in working with individuals with a variety of cultural backgrounds.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors progress to ensure performance goals are being met.
Conveys expectations for meeting performance metrics.
Initiates a performance improvement plan for underperforming subordinates.
Holds the team leader accountable for the team meeting key performance responsibilities.
Quality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Always strives to produce the highest quality work products.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Reflects on what is working and what could be improved.
Corrects issues in a timely manner.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes tasks ahead of schedule.
Keeps accurate records of time spent on projects for proper billing.
Focuses time on the tasks that yield the highest value.
Efficiently completes tasks.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes immediate action toward goals.
Coordinates all department activities into a cohesive team effort.
Able to focus on a task even when working alone.
Committed to the team.
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Demonstrates mastery of the technical competencies required in his/her work.
Willingly shares his/her technical expertise; sought out as resource by others
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Knows how to produce high quality products/work.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is aware of federal and local laws affecting employees.
Offers training to employees to ensure they comply with regulations.
Works quickly to implement changes in regulations.
Implements regulatory changes in a timely manner.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Persuades others to follow the Company's vision.
Demonstrates consistency between words and actions
Communicates the vision and strategy of [Company]
Leads employees in new directions.

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.