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

Self Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Consciously controls own negative emotions in order to keep team morale up.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Uses patience and self-control in working with customers and associates.
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
Inspires creativity in their team.
Is creative and inspirational.
Conceives, implements and evaluates ideas.
Creates a lot of new ideas.
Develops solutions to challenging problems.
Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Seeks knowledge and information about other cultures.
Is open and honest in communications with individuals from other cultures.
Is responsive to individuals from other cultures.
Encourages a work environment where individual differences are valued.
Recognizes individual and cultural differences.
Problem Solving	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Skilled at quickly diagnosing issues, identifying root causes, and developing and implementing effective solutions in the workplace.
Ability to develop innovative solutions to problems.
Effective in solving problems.
Solves problems using logic and insight.
Makes judgments based upon relevant information.
Juggling Multiple Responsibilities	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ranks the importance of tasks to make sure critical tasks are completed first.
Is aware of the deadlines for specific tasks/assignments.
Assigns tasks based on skills of team members.
Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
Builds in extra time in the schedule for unplanned events/occurrences.
Clarity	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Communicates with clarity and efficiency.
Clearly explains responsibilities to individuals.
Seeks to reduce ambiguity in messaging and documents.
Is clear about the roles and duties of team members.
Attends to the important details of a job or task.
Regulatory/Compliance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Provides direction and oversight for the compliance department.
Maintains historical records and documents as needed/required.
Ensures the company meets legal requirements/standards regarding employees.
Effectively communicates the importance of meeting compliance standards.
Submits complete applications for necessary certifications.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Searches for a common solution to shared problems or issues.
Provides expertise that may be lacking in other partners or other parts of the network.
Is an active member of professional associations or professional groups to stay connected with peers.
Builds alliances between departments and teams.
Leverages core competencies of partners to the benefit of both parties.

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.