Trustworthy - 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

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Trustworthy	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Takes care to maintain confidential information.
Works in a way that makes others want to work with her/him.
Is trustworthy; is someone I can trust.
Demonstrates congruence between statements and actions.
Consistently keeps commitments.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Strong organizational skills to keep the workspace and department in order
Has strong technical/computer skills.
High attention to detail.
Accurately implements contract provisions.
Able to develop, justify and present a budget.
Flexibility	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Accommodates the needs of employees as best as possible when requests for time off are made.
Embraces change and is willing to pivot strategies based on new information.
Is open to and values diverse perspectives.
Embraces uncertainty with confidence and creativity to find solutions amidst chaos.
Is flexible in responding to customer needs.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Contributes to a positive and fun work environment.
Works to eliminate unnecessary work or barriers that get in others' way.
Treats all people fairly and with respect.
Builds open and trusting relationships.
Shows by their actions that they trust in the positive intentions of others.
Emotional Intelligence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Able to understand others' points of view.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to express themselves clearly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Managing Performance	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Gives additional responsibilities to individuals who exceed standards.
Makes sure employees understand what is expected of them.
Makes sure the team's goals are met.
Measures performance of goals and objectives.
Makes sure commitments are understood and met.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Develops a strong safety culture.
Is aware of OSHA safety guidelines.
Ensures that all supervisors are aware of regulatory and compliance measures.
Ensures compliance with safety regulations.
Is not afraid to question a potential safety issue observed in the workplace.
Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Cultivates an environment that embodies the department's vision.
Committed to undertaking the implementation of the strategic vision.
Demonstrates consistency between words and actions
Creates and executes a strategic vision that drives the company's growth forward.
Assigns the vision implementation to team members.

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.