Results Oriented - 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

Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Exceeds performance requirements.
Stays focused on solving problems and getting work done.
Determines what resources will be needed to achieve the objectives.
Overcomes obstacles to continue working toward goals.
Completes all assigned tasks.
Directs team in prioritizing daily work activities
Promptly and efficiently completes assigned tasks.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages me to take on greater responsibility.
Consistently provides me with timely feedback for improving my performance.
Ability to establish realistic goals.
Effectively organizes resources and plans
Assures [Company] principles are understood, employed & pursued.
Organizes and schedules events, activities, and resources.
Able to organize work.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Leverages core competencies of partners to the benefit of both parties.
Develops effective peer to peer working relationships.
Exchanges innovative ideas with others in the network.
Supports and encourages relationships that are created by diverse team members.
Ensures that lessons learned from the partnership are disseminated and built upon.
Partners with other organizations to develop new technologies and processes.
Can perform a SWOT analyses (Strengths, Weaknesses, Opportunities, Threats) of the partnership's potential outcomes.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Impresses upon others the important aspects of [Company].
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Supports [Company]'s strategic objectives.
Attends [Company] gatherings and social events.
Maintains positive relationships between the [Company] and the community.
Effectively represents the department in company gatherings.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Delegates role to team members to accomplish goals.
Develops strategic plans for ensuring competitiveness in the marketplace.
Creates to-do lists to make sure nothing is missed.
Able to identify the needs of the department before a major change.
Establishes a course of action for self and others to accomplish specific goals.
Creates a timeline to specify when each phase of the project should be concluded.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Inspires others to learn new things.
Sets achievable learning goals to develop new skills.
Is committed to enhancing their own knowledge and skills.
Holds self and associates accountable for goal achievement.
Enhances value to the company through additional training and development.
Enrolls in certification classes when available.
Enjoys learning new skills and techniques.

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

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

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