Self-Management - 360 Degree Feedback Survey Sample #5

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

Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Adds value to the department/organization.
Is creative.
Is creative and inspirational.
Creates a lot of new ideas.
Conceives, implements and evaluates ideas.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Respects others regardless of age, race, gender, nationality, or disability.
Recognizes and values individual and cultural differences.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Values the opinions of diverse groups and individual.
Fosters a diverse workforce free from discrimination and harassment.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Solves problems using logic and insight.
Is a good problem solver and decision maker
Identifies and assesses all potential responses to a problem.
Effective in solving problems.
Ability to solve problems at root cause rather than at symptom level.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Plans and organizes continuously while performing all other responsibilities and activities.
Bounces back from daily crisis, disappointments and frustrations.
Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Avoids stating unclear or conflicting goals.
Makes sure goals and objectives are clearly and thoroughly explained and understood.
Clarifies problems and their causes to help employees correct them.
Checks details thoroughly.
Attends to the important details of a job or task.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Explains regulations and procedures to others as required.
Ensures regulations are followed as required.
Follows all safety regulations and procedures.
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Keeps informed of various regulations and procedures.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Partners with peers to obtain influence within the Company.
Builds alliances between departments and teams.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Supports a partnering/networking culture.
Creates value within the Company by building networks.

41. Overall, please rate the effectiveness of .
    

    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 's assessment.