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

Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are able to organize work.
You have great overall performance
You work effectively in the department.
You shown significant improvement in job performance.
You are effective in performing your job.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assess employees' developmental needs.
You support the successes of other employees.
You recognize and celebrates accomplishments of others.
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
You discuss conflict situations with supervisor.
You assist team members by helping them see the other point of view.
You clearly express expectations to others.
You identify and takes steps to prevent potential confrontations.
You try to understand others' point of view before making judgments
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You ensure the department has a viable strategy for moving forward.
I identify and address strategic risks impacting operations.
I strategically position resources to meet the needs of branch locations.
You reinforce the strategic messaging in various teams, meetings, seminars and workshops.
You identify areas where return on investment can be improved.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop of the department's annual budget.
You are effective in using company's resources.
You develop budgets and plans for various programs and initiatives.
You monitor spending.
You provide budgeting and accounting support to the Company.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I schedule staff based on seasonal needs.
You determine what supplies/equipment will be needed for the department.
You are able to balance the needs of multiple stakeholders in developing the plan for the division.
You purchase equipment and software that will be needed in the future.
I determine the allocation of funds based on plans for future development.

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.