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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Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Results Oriented	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets challenging personal and organizational goals.
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Provides clear expectations for employees.
Holds employees accountable for completing required work.
Embraces setbacks and challenges as opportunities to learn.
Exhibits high energy and a positive attitude on the job with others
Explains the "whys" behind organizational objectives
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages me to take on greater responsibility.
Communicates goals and objectives to employees.
Organizes and schedules events, activities, and resources.
Effectively organizes resources and plans
Establishes goals and objectives.
Able to organize work.
Ability to establish realistic goals.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Maintains infrastructure to support partnerships and networks.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Builds alliances between departments and teams.
Creates value within the Company by building networks.
Supports and encourages relationships that are created by diverse team members.
Collaborates with others to accomplish goals and objectives.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Impresses upon others the important aspects of [Company].
Supports [Company]'s marketing efforts.
Follows existing procedures and processes.
Effectively represents the department in company gatherings.
Understands the "basics" as to how [Company] functions/operates.
Understands the use of [Company] products and services.
Attends [Company] gatherings and social events.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works in an organized manner
Able to identify the needs of the department before a major change.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Makes plans and follows through.
Anticipates obstacles and ways to overcome them.
Delegates role to team members to accomplish goals.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Embraces new technology and procedures.
Constantly enhances product knowledge through experimentation and play.
Is highly motivated to learn new skills.
Willing to learn new procedures for working with the equipment.
Demonstrates through personal behavior the commitment to high standards of performance.
Enhances value to the company through additional training and development.
Demonstrates a willingness to learn new things.

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.