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
Recognizes team members who offer a significant contribution to a project.
Offers recognition in a timely manner.
Reinforces and rewards employees for accomplishing necessary goals.
Recognizes individuals for a specific outstanding achievement.
Readily shares credit and gives others opportunity for visibility.
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adjusts plans to meet new situations.
Is open to new ideas and innovations.
Adjusts tactics and strategies.
Handles changes easily.
Able to adjust to changes as needed.
Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is open to new ideas and concepts.
Pursues professional development opportunities when they arise.
Shares best practices with others and learns from others.
Participates in regular training offered.
Pursues learning that will enhance job performance.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Delegate tasks effectively
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Sets an example for others to follow
Is ready to offer help
Decision Making	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes decisions that support the department's goals and objectives.
Evaluates information before making a final decision.
Maintains focus on the "big picture" when making decisions.
Acts confidently in the absence of guidance.
Defines parameters that will impact the decision making process.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Rapidly completes tasks and assignments.
Increased production by 20 percent.
Demonstrates a sense of urgency to quickly and accurately solve problems and issues.
Sets challenging goals.
Successfully launched the ABC project.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maximizes the use of new technology to deliver products and services.
Understands and is committed to implementing new technologies.
Uses technology in decision making and problem solving.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Engages with clients on multiple levels.
Maintains up-to-date information regarding client products.
Ensures client commitments and requirements are met or exceeded
Helps others in responding to client needs.
Anticipates resources needed to meet the client needs.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Analyzes records and reports to obtain insight into potential issues and trends.
Analyzes unique issues or problems impacting the Company.
Implements long-term solutions to problems.
Creates strategies that significantly benefit the Company.
Recognizes the needs of customers.

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.