Self-Management - 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

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.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Consciously controls own negative emotions in order to keep team morale up.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Creativity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Conceives, implements and evaluates ideas.
Adds value to the department/organization.
Inspires creativity in their team.
Is creative.
Creates a lot of new ideas.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is open and honest in communications with individuals from other cultures.
Seeks knowledge and information about other cultures.
Hires individuals with different cultural backgrounds for the department.
Is curious and willing to ask questions about the cultural differences in the workplace.
Is aware of differences in how individuals from other cultures greet one another.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Generates alternative solutions to problems and challenges.
Is a good problem solver and decision maker
Implements effective solutions to critical problems.
Finds creative ways to get things done with limited resources.
Able to balance the needs of different people in a solution to a problem.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Can multitask while performing all of their other responsibilities and activities.
Organizes tasks for the most efficient order of completion.
Ranks the importance of tasks to make sure critical tasks are completed first.
Completes multiple tasks simultaneously.
Determines which tasks are critical and which tasks are optional.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates ideas and facts clearly and effectively in writing.
Makes sure employees understand why they were given certain assignments.
Uses appropriate grammar and tense in communications.
Provides a clear vision for the future.
Clearly explains responsibilities to individuals.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Familiar with EEOC, FLSA, OSHA and ERISA acts/standards.
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Keeps up-to-date with legislation affecting employees.
Is aware of federal and local laws affecting employees.
Explains regulations and procedures to others as required.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Partners with peers to obtain influence within the Company.
Creates value within the Company by building networks.
Supports and encourages relationships that are created by diverse team members.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Supports a partnering/networking culture.

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.