Planning- 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.

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

Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to identify the needs of the department before a major change.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Works in an organized manner
Makes plans and follows through.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps excellent records for financial transparency.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Provides budgeting and accounting support to the Company.
Develops of the department's annual budget.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Offers recognition in a timely manner.
Says "thank you" to show appreciation for work of others.
Reinforces and rewards employees for accomplishing necessary goals.
Readily shares credit and gives others opportunity for visibility.
Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Completes work on time
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Seeks and utilizes opportunities for continuous learning and self-development.
Completes a large volume of work.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks out different viewpoints and benefits from different perspectives.
Treats others with dignity and respect.
Recognizes and values individual and cultural differences.
Respects others regardless of age, race, gender, nationality, or disability.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures team members understand the department goals.
Sets long and short term goals.
Makes sure commitments are understood and met.
Presents performance feedback in a clear and concise manner.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides clear expectations for employees.
Explains the "whys" behind organizational objectives
Stays focused on meeting the needs of customers.
Works toward achievement of goals even when confronted with obstacles.
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willingly shares information and expertise; sought out as resource by others
Knows how to produce high quality products/work.
Willingly shares his/her technical expertise; sought out as resource by others
Is knowledgeable of procedures or systems necessary for the job.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes a lot of pride in their work.
Can be counted on to add value wherever they are involved.
Produces high quality work.
Demonstrates the functional or technical skills necessary to do their job.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
Ensures all customer commitments and requirements are met or exceeded.
...friendliness and courtesy
Develops strong customer relationships.

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.