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.

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Thank you for your participation in the survey.

Management Team

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Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Recognizes the abilities and skills of self and others
Lets employees know when they have done well
Recognizes team members who offer a significant contribution to a project.
Readily shares credit and gives others opportunity for visibility.
Is sincerely interested in the suggestions of co-workers
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Handles changes easily.
Adapts to new environments.
Accommodates changes as needed.
Is aware of changes in the environment.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Continual Learning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Improves on their skill sets.
Participates in regular training offered.
Is open to new ideas and concepts.
Grasps new ideas, concepts, technical, or business knowledge.
Takes the initiative to learn new skills.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Makes you feel enthusiastic about your work
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Is ready to offer help
Sets an example for others to follow
Decision Making	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Defines what constraints must be met for the decision making process.
Makes decisions independently (without having to be told what or how).
Makes good decisions for the department.
Receptive to new ideas from others when making decisions.
Is able to make decisions quickly.
Achievement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Increased production by 20 percent.
Eliminates bureaucratic barriers to streamline processes.
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Helps others to improve or meet standards of performance.
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.
Supports employee training and development initiatives regarding implementation of technology.
Adopts the implementation of new technology into the workplace.
Applies complex rules and regulations to maintain optimal system performance.
Proficient in the use of technical systems and processes.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures clients are comfortable with the services provided.
Helps others in responding to client needs.
Demonstrates a commitment to client focus.
Anticipates and proactively resolves issues that the client may face.
Helps clients feel they are receiving services tailored specifically to their needs.
Strategic Insight	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Lets employees know how their roles contribute toward the achievement of strategic company objectives.
Creates a vision for the organization based on insights gathered from other companies in the industry.
Formulates policies and strategies for addressing the Company's important challenges.
Creates values statement to ensure all employees are working under the same guiding principles.
Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.

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.