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
Analyze what occurred and re-adjusts accordingly when goals are not met.
Implements appropriate training to maintain high quality standards.
Communicates quality standards clearly.
Creates effective policies regarding quality of services and products.
Is innovative and creative in response to issues involving quality of the products.
Communicates with team members regarding best quality practices.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops plans for following through on the changes.
Adopts changes to set and example for others to follow.
Works cooperatively with others to implement changes.
Effective in dealing with ambiguous and challenging situations.
Effective in implementing new organizational vision and values.
Able to get team members to change their attitudes.
Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Acts as a resource without removing individual responsibility.
Is a person you can trust.
...takes personal responsibility for results.
Sets a good example.
Responsible for setting the vision of the department.
Works in a way that makes others want to work with her/him.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides constructive feedback to others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Tries to ensure employees are ready to move to the next level.
Is open to receiving feedback.
Encourages employees through recognition of positive changes in behavior.
Assesses employees' developmental needs.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Addresses employee behavior problems effectively.
Provides clear, motivating, and constructive feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Conducts regular performance appraisals and feedback.
Helps employees to maintain high personal standards.
Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is able to see issues from others' perspectives.
Consistently demonstrates ability and willingness to trust others.
...treats others with respect and dignity.
Helpful
Respects the opinions of other employees.
Treats others with respect and dignity.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands how decisions impact other business units beyond their immediate department of work group.
Follows existing procedures and processes.
Impresses upon others the important aspects of [Company].
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.
Understands the use of [Company] products and services.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Engages in problem solving with individuals outside of the country.
Able to work with others from different cultures and countries.
Demonstrates working knowledge of global transactions.
Communicates effectively on a multi-lingual basis.
Facilitates open communication with individuals from other countries.
Understands how cultures differ and how these differences impact work behavior.

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.