Performance - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. 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 you at the conclusion of this assessment to help guide your ongoing professional 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

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Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You set a high standard for job performance.
You work well in this position.
You work effectively in the department.
You effectively organize resources and plans
You are effective in performing your job.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assign tasks and responsibilities to develop skills of others.
You set performance objectives for subordinates that encourages development opportunities.
You try to ensure employees are ready to move to the next level.
You provide constructive feedback to others.
You encourage employees through recognition of positive changes in behavior.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I promote employee engagement to reduce tensions and negativity, creating an environment where conflicts are easily managed.
I persuade individuals to alter their underlying work behaviors which may have led to the conflict.
I work to reduce misunderstandings and poor communication.
I demonstrate how to de-escalate through tone, body language, and word choice.
You are able to persuade and influence others.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I detect changes in the environment and updates the strategic plan to address new opportunities or threats.
I develop strategies to increase efficiency and reduce environmental impacts.
make strategic decisions that take into account a dynamic situation.
I give adequate consideration to the time and resources available.
You communicate goals and objectives to employees.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop of the department's annual budget.
You ensure others follow the correct rules and regulations on fiscal matters.
You monitor expenses and verify the need for items purchased.
You monitor spending.
You are effective in using company's resources.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I determine staffing needs for the project/department.
You assess the potential impact of changes to the strategic plan.
I have plans to handle unexpected events.
You are able to balance the needs of multiple stakeholders in developing the plan for the division.
I can determine the amount of materials/supplies needed for the project.

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

    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 [Participant Name Here]'s assessment.