Recognition- 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

Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Lets employees know when they have done well
Says "thank you" to show appreciation for work of others.
Offers recognition in a timely manner.
Finds opportunities to recognize others.
Readily shares credit and gives others opportunity for visibility.
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Able to adapt to changes in technology and processes.
Works effectively in dynamic and changing work environments.
Flexible and open to new ideas and encourages others to value change.
Recognizes and implements changes to enhance efficiency and effectiveness.
Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Grasps new ideas, concepts, technical, or business knowledge.
Sets relevant learning objectives and goals.
Seeks opportunities to grow in skills and knowledge.
Pursues self-improvement through continual learning.
Pursues learning that will enhance job performance.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets an example for others to follow
Delegate tasks effectively
Keep staff informed about what is happening in the company
Is ready to offer help
Takes responsibility for things that go wrong
Decision Making	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Does not lose sight of the big picture when making decisions
Exercises good judgment by making sound and informed decisions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
Is able to make decisions quickly.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Follows-up and takes action when goals are not met to ensure better results in the future.
Driven to complete goals despite obstacles that may arise.
Completes work promptly and efficiently.
Demonstrates a sense of urgency to quickly and accurately solve problems and issues.
Sets ambitious standards of performance.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands and is committed to implementing new technologies.
Uses technology in decision making and problem solving.
Supports technical training and development of employees.
Applies complex rules and regulations to maintain optimal system performance.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Satisfies client needs.
Forms strong client relationships
Obtains feedback to ensure client needs are being met.
Looks for opportunities that have a positive impact on Clients.
Maintains strong relationships with clients.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Formulates policies and strategies for addressing the Company's important challenges.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Analyzes records and reports to obtain insight into potential issues and trends.
Communicates vision for the department and company.
Identifies potential problems before they become critical incidents.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.