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
Makes people around them feel appreciated and valued.
Recognizes individuals for a specific outstanding achievement.
Reinforces and rewards employees for accomplishing necessary goals.
Recognizes the abilities and skills of self and others
Lets employees know when they have done well
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adjusts to new plans and procedures.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Develops insights and applies innovative solutions to projects and problems.
Adjusts plans to meet new situations.
Adjusts plans as needed based on changing conditions.
Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Improves on their skill sets.
Shares best practices with others and learns from others.
Views setbacks as opportunities to learn from.
Pursues learning that will enhance job performance.
Takes charge of their training and skills enhancement.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets an example for others to follow
Makes you feel enthusiastic about your work
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Delegate tasks effectively
Decision Making	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes creative decisions.
Is creative about the decisions they make.
Decides which long-term goals should be met.
Understands how different perspectives can help make better informed decisions.
Makes decisions based on novel interpretations of the facts.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Takes calculated risks to achieve significant rewards.
Driven to complete assignments on time.
Completes work to given time frame and to budget
Sets challenging goals.
Technology Use/Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Applies complex rules and regulations to maintain optimal system performance.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Uses technology in decision making and problem solving.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is consistent in services provided to clients.
Delivers on commitments made to clients.
Forms strong client relationships
Focuses on the unique needs of each client.
Provides training to others on how to improve client service.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Creates strategies that significantly benefit the Company.
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Recognizes the needs of customers.
Analyzes records and reports to obtain insight into potential issues and trends.
Pursues strategic alliances with valued partners.

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.