Quality - 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

Quality	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides regular and timely feedback on quality levels.
Creates a culture of quality standards in the workplace.
Develops measures of the success of quality initiatives.
Is innovative and creative in response to issues involving quality of the products.
Creates quality improvement programs and processes.
Successfully implements quality controls within the department.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Addresses organizational and departmental resistance to changes.
Inspires others to accept changes.
Assists others in understanding changes to the organization.
Able to get team members to change their attitudes.
Adopts changes to set and example for others to follow.
Inspires others to want to change.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works in a way that makes others want to work with her/him.
Behavior is ethical and honest.
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Responsible for setting the vision of the department.
Acts as a resource without removing individual responsibility.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Assesses employees' developmental needs.
Is open to receiving feedback.
Encourages employees through recognition of positive changes in behavior.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Creates a work environment that fosters positive feedback to employees.
Tries to ensure employees are ready to move to the next level.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Helps employees to understand responsibilities, authority, and expectations.
Helps employees to maintain high personal standards.
Provides clear, motivating, and constructive feedback.
Conducts regular performance appraisals and feedback.
Develops the skills and capabilities of others.
Meets regularly with employees to coach them on areas that will enhance their performance
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Constructively receives criticism and suggestions from others.
Works effectively with people from other departments.
...treats others with respect and dignity.
Forms working relationships with employees from other departments.
Includes others in the decision making processes.
Able to see issues from others' perspectives.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the "basics" as to how [Company] functions/operates.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.
Understands global systems such as the global economy.
Demonstrates working knowledge of global transactions.
Is aware of the culture, behaviors, identities and beliefs of others.
Builds working relationships with others across cultures.
Cooperates with others on a global scale.

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

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

    
    
50. Strengths
    
    
    
51. Areas for Development
    
    
    
52. Please give any final comments or suggestions for [Participant Name Here]'s assessment.