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
Pursues performance benchmarks despite obstacles and setbacks.
Motivated by a strong desire to exceed performance standards.
Provides clear expectations for employees.
Does not become distracted by non-issues or interruptions.
Inspires and motivates co-workers to be productive and energetic at work
Sets objectives for the department.
Highly motivated to complete tasks despite obstacles that may arise.
Objectives	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Encourages me to take on greater responsibility.
Sets long-term and short-term goals.
Organizes and schedules events, activities, and resources.
Establishes goals and objectives.
Consistently provides me with timely feedback for improving my performance.
Assures [Company] principles are understood, employed & pursued.
Works toward achieving established goals and objectives.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Works in tandem with colleagues to pursue common goals and needs.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Attends industry conferences and seminars to meet new contacts and learn from industry leaders.
Searches for a common solution to shared problems or issues.
Maintains a network of partners and suppliers to facilitate global operations.
Collaborates with other departments to streamline and improve workflow efficiency.
Effectively develops networks with colleagues that have shared interests.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands the "basics" as to how [Company] functions/operates.
Understands the use of [Company] products and services.
Expresses loyalty and dedication to [Company] in interactions with others.
Supports [Company]'s strategic objectives.
Impresses upon others the important aspects of [Company].
Understands how decisions impact other business units beyond their immediate department of work group.
Effectively represents the department in company gatherings.
Planning	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Reorders the schedule of events to maximize attendance/efficiency.
Open to input from others into the plan for the project.
Ensures staff have the supplies and resources necessary to enact the plan.
Identifies resource requirements that may impact the development of the 5-year plan.
Determines the appropriate actions needed to achieve goals.
Ensures everyone in the department is onboard with the current plan.
Allows input from others for the 5-year plan.
Passion To Learn	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Sets achievable learning goals to develop new skills.
Stays current with skills and training.
Embraces new technology and procedures.
Critiques own performance and learns from experience as a source of continuous improvement.
Will participate in training classes even if offered outside of normal working hours.
Inspires others to learn new things.
Exhibits willingness to upgrade skills through additional training and education.

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.