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.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Edit this Survey

Would you like to edit this survey? Click here to begin.

Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Steps away from a situation to process appropriate response.
Does not allow own emotions to interfere with the performance of others.
Uses patience and self-control in working with customers and associates.
Analyzes interpersonal problems instead of reacting to them.
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
Is creative.
Develops solutions to challenging problems.
Creates a lot of new ideas.
Adds value to the department/organization.
Is creative and inspirational.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Is open and honest in communications with individuals from other cultures.
Recognizes and values individual and cultural differences.
Seeks clarification to avoid misunderstandings.
Views diversity as a strength, not as an issue.
Is aware of the similarities and differences among and between cultural groups.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ability to solve problems at root cause rather than at symptom level.
Asks the right questions to size up or evaluate situations.
Maximizes the return on investment in problem-solving efforts by using resources wisely.
Utilizes concrete measures of the gap between expected and observed outcomes so that the effectiveness of solutions can be determined.
Conducts ongoing monitoring and follow-up to ensure the solution's continued success and to catch any unintended consequences.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Keeps track of multiple assignments and deadlines.
Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
Ensures that assignments are prioritized according to the needs of the department/company.
Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
Determines which tasks are critical and which tasks are optional.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Writes clear job descriptions for positions in the organization.
Maintains clarity in goals and objectives.
Communicates ideas and facts clearly and effectively in writing.
Clarifies problems and their causes to help employees correct them.
Avoids creating ambiguity or mixed messages.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Prepares and presents annual reports as required.
Creates a company compliance manual for distribution to the employees.
Develops compliance reports in accordance with federal and industry regulations.
Develops compliance reports to share with stakeholders.
Provides documents and reports as needed to maintain compliance with laws.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks to avoid conflicts by clarifying problems early on and working quickly to resolve those issues.
Creates strategic partnerships when resources are limited.
Develops alliances with colleagues at other companies.
Can perform a SWOT analyses (Strengths, Weaknesses, Opportunities, Threats) of the partnership's potential outcomes.
Able to highlight both the strategic benefits and potential pitfalls in collaboration.

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.