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 set a high standard for job performance.
You shown significant improvement in job performance.
You produce quality
You work effectively in the department.
You effectively organize resources and plans
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are open to receiving feedback.
You create a work environment that fosters positive feedback to employees.
You assess employees' developmental needs.
You try to ensure employees are ready to move to the next level.
You assign tasks and responsibilities to develop skills of others.
Conflict Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You discuss conflict situations with supervisor.
You help employees to think through alternative ways to resolve conflict situations.
You assist team members by helping them see the other point of view.
You try to understand others' point of view before making judgments
You identify and takes steps to prevent potential confrontations.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
You communicate goals and objectives to employees.
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
You sustain or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
You look for opportunities to enhance contributions to the bottom line.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop of the department's annual budget.
You monitor expenses and verify the need for items purchased.
You are effective in using company's resources.
You develop budgets and plans for various programs and initiatives.
You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assign the right tasks to the right people and holds them accountable.
I can develop a detailed plan outlining tasks, resources, timelines, and deliverables.
I can adjust and rearrange the schedule to maximize efficiency.
I accurately estimate the duration of tasks.
You anticipate obstacles and ways to overcome them.

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.