Responsibility - 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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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets a good example.
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Acts as a resource without removing individual responsibility.
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can take on new assignments.
Is open to new ideas and innovations.
Effective in working with different personnel of the team.
Adjusts tactics when things are not working as expected.
Is aware of changes to team personnel.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses patience and self-control in working with customers and associates.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Steps away from a situation to process appropriate response.
Analyzes interpersonal problems instead of reacting to them.
Emotional Intelligence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Accurately perceives the emotional reactions of others.
Is able to manage their own emotions.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keep staff informed about what is happening in the company
Is ready to offer help
Sets an example for others to follow
Delegate tasks effectively
Takes responsibility for things that go wrong
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works cooperatively with others to solve problems.
Able to balance the needs of different people in a solution to a problem.
Generates alternative solutions to problems and challenges.
Actively seeks the root cause of a problem.
Implements effective solutions to critical problems.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Focuses efforts on specific marketing strategies.
Makes strategic decisions that take into account a dynamic situation.
Develops a corporate strategy to establish business operations in different locations.
Detects changes in the environment and updates the strategic plan to address new opportunities or threats.
Is effective in using strategic tools such as value chain analysis, business environment analysis, and competitor analysis.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops budgets and plans for various programs and initiatives.
Monitors expenses and verifies the need for items purchased.
Provides budgeting and accounting support to the Company.
Develops of the department's annual budget.
Keeps excellent records for financial transparency.

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

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.