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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Thank you for your participation in the survey.

Management Team

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Responsible	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets a good example
Acts as a resource without removing individual responsibility.
Responsible for setting the vision of the department.
Behavior is ethical and honest.
Sets a good example.
Adaptability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Works effectively in dynamic and changing work environments.
Handles unexpected events without a loss of productivity.
Is aware of changes to the policies and procedures.
Is open to new ideas and innovations.
Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Steps away from a situation to process appropriate response.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Consciously controls own negative emotions in order to keep team morale up.
Emotional Intelligence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Accurately perceives the emotional reactions of others.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Able to understand others' points of view.
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to control their own emotions.
Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets an example for others to follow
Is ready to offer help
Keep staff informed about what is happening in the company
Takes responsibility for things that go wrong
Delegate tasks effectively
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses a structured process to evaluate ideas generated from a brainstorming session based on their feasibility, cost, potential impact, and alignment with business goals.
Collects relevant information and data.
Invests in training and development programs to equip team members with the skills and knowledge they need to identify and solve problems effectively.
Identifies and analyzes potential risks in advance.
Uses charting tools to identify patterns in data.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Coordinates the implementation of the strategy with stakeholders.
Identifies and focuses resources on strategic growth opportunities.
Creates a strategy to pursue and maintain a competitive advantage in business.
Aligns cross-functional teams to the strategic plan.
Makes sure the objectives are clearly communicated and understood.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps excellent records for financial transparency.
Effective in using Company's resources.
Monitors spending.
Monitors expenses and verifies the need for items purchased.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.

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.