Passion to Learn - 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.

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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Exhibits willingness to upgrade skills through additional training and education.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Takes initiative for own learning and development.
Creates an environment that supports personal development and exploration.
Stays up-to-date on emerging technologies.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Looks for ways to expand current job responsibilities.
Promotes training and development opportunities to enhance job performance.
Looks for ways to expand and learn new job skills.
Analyzes processes to determine areas for improvement.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops solutions to challenging problems.
Conceives, implements and evaluates ideas.
Is creative and inspirational.
Creates a lot of new ideas.
Adds value to the department/organization.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Driven to complete goals despite obstacles that may arise.
Uses established goals and performance measures to keep track of performance.
Sets performance metrics to measure achievement or attainment of goals.
Allocates resources as needed to accomplish organizational goals.
Completed required training and certification.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Attends to the important details of a job or task.
Writes clear job descriptions for positions in the organization.
Avoids stating unclear or conflicting goals.
Clearly explains the vision and goals of the company.
Clearly defines work objectives for employees.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures the company is in compliance with industry specifications, standards, and applicable laws.
Ensures operations meet government and industry requirements/standards.
Complies with regulatory requirements for the state.
Develops and implements a compliance data recordkeeping system.
Trains and coordinates activies of compliance officers.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures others follow the correct rules and regulations on fiscal matters.
Develops budgets and plans for various programs and initiatives.
Provides budgeting and accounting support to the Company.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Monitors spending.

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.