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 balance the needs of multiple stakeholders in developing the plan for the division.
Develops strategic plans for the company/organization.
Involves relevant coworkers in the development of the plan.
Determines the appropriate actions needed to achieve goals.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Monitors spending.
Keeps excellent records for financial transparency.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Provides budgeting and accounting support to the Company.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes individuals for a specific outstanding achievement.
Lets employees know when they have done well
Compliments other people when they do good work
Says "thank you" to show appreciation for work of others.
Bias for Action	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Displays high energy and enthusiasm on consistent basis.
Conveys a sense of urgency about addressing problems and opportunities
Encourages risk taking and experimentation to improve performance
Motivates others to achieve or exceed goals
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands what customs and etiquette are important for individuals from other cultures.
Values the opinions of diverse groups and individual.
Seeks to reduce obstacles in communication that might arise from cultural differences.
Is willing to include individuals with different cultural backgrounds on the team.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses timely and appropriate corrective/disciplinary actions.
Continuously measures performance and provides feedback to employees regularly.
Makes sure the team's goals are met.
Sets long and short term goals.
Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Stays focused on meeting the needs of customers.
Helps others when free-time is available.
Explains the "whys" behind organizational objectives
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Technical	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Is knowledgeable of procedures or systems necessary for the job.
Seeks information from others as needed.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is planful and organized.
Produces high quality work.
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Customer Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Follows up with any unanswered questions from the customer.
Tailors solutions to meet the specific needs of each customer.
Consistently meets customer's needs.
Uses customer feedback to help improve products and services.

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.