Performance - 360 Degree Feedback Survey Sample #5

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

Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Effectively organizes resources and plans
...Produce Quality
Sets a high standard for job performance.
Listens and responds to issues and problems
Has great overall performance
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates a work environment that fosters positive feedback to employees.
Creates opportunities for professional development.
Provides constructive feedback to others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Sets performance objectives for subordinates that encourages development opportunities.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Tries to understand others' point of view before making judgments
Identifies and takes steps to prevent potential confrontations.
Helps employees to think through alternative ways to resolve conflict situations.
Deals effectively with employee grievances.
Clearly expresses expectations to others.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to decline a poor strategy by proposing alternate strategies.
Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
Understands & contributes to development of strategic goals.
Communicates goals and objectives to employees.
Looks for opportunities to enhance contributions to the bottom line.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops budgets and plans for various programs and initiatives.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Monitors expenses and verifies the need for items purchased.
Keeps excellent records for financial transparency.
Monitors spending.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Anticipates obstacles and ways to overcome them.
Makes plans and follows through.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Delegates role to team members to accomplish goals.
Able to identify the needs of the department before a major change.

31. Overall, please rate the effectiveness of .
    

    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 's assessment.