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
Helpful
Is able to see issues from others' perspectives.
Respects the opinions of other employees.
Constructively receives criticism and suggestions from others.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Looks for ways to improve work processes and procedures.
Promotes training and development opportunities to enhance job performance.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Looks for ways to expand current job responsibilities.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Fosters a diverse workforce free from discrimination and harassment.
Interacts effectively with people from different cultural backgrounds.
Functions effectively within various cultural contexts.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is proactive in administering the rewards program.
Ensures employees are trained in areas where performance may be lacking.
Informs the employee of the required sales/production targets.
Communicates the roles and responsibilities to the employee.
Quality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Implements appropriate training to maintain high quality standards.
Verifies the operators have the necessary equipment and supplies to ensure high quality.
Identifies appropriate sources of quality standards.
Analyzes quality improvement plans and initiatives.
Time Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is productive for the majority of time spent during the day.
Sets a good balance between work and family life.
Adheres to project timelines.
Combines tasks to save time.
Commitment To Result	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Committed to the team.
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.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is knowledgeable of procedures or systems necessary for the job.
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Seeks information from others as needed.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is aware of the documents and reports needed to maintain compliance with regulations.
Follows all safety regulations and procedures.
Offers training on various subjects to help ensure employees are aware of regulations.
Responds promptly to inquiries from regulatory bodies.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adept at creating and actualizing a strategic roadmap for the organization.
Works to support the strategy of [Company]
Promotes a vision that inspires individuals to take risks to achieve greater rewards.
Demonstrates consistency between words and actions

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.