Accountability - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others. A report will be shared with you at the conclusion of this project.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

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Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I acknowledge errors and take the steps necessary to rectify them.
You take full responsibility for project outcomes.
You accept accountability for your work.
You hold employees accountable for their participation in solving department problems and issues.
I take full responsibility for results.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You enjoy learning new skills and techniques.
You will participate in training classes even if offered outside of normal working hours.
You stay up-to-date on emerging technologies.
You constantly enhance product knowledge through experimentation and play.
You take advantage of training opportunities when they arise.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make sure that employees understand how their work relates to organizational goals.
You help guide employees with prioritizing tasks.
You maintain self-control when personally criticized.
You function well under stress, deadlines, and/or significant workloads.
You are excellent at managing time.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to express own goals and needs.
You develop a good rapport with others.
You have excellent influencing/negotiating skills.
You persuade others to consider alternative points of view.
You communicate effectively with others.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You promote innovation as an opportunity to gain competitive advantages in the marketplace.
I establish and monitors key performance indicators (KPIs) for innovation.
I understand that innovation requires doing things differently.
You celebrate innovative achievements publicly to motivate others and reinforce the importance of innovation.
I support changes to the standard way of doing things.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to successfully launch the ABC project.
Your work improves the quality of work on the production line.
You make use of talents of others to help achieve a high level of performance.
You allocate resources as needed to accomplish organizational goals.
You hold others to high standards of achievement.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate good communication with colleagues and customers.
I am well respected in the department.
I give credit where credit is due.
You are easily approachable.
You use tact, compassion, and sensitivity in interactions with others.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set and clearly communicate expectations, performance goals, and measurements to others
You give others development opportunities through project assignments and increased job responsibilities
You work to identify root causes of performance problems
You provide ongoing feedback to co-workers on your development progress
You take immediate action on poor performance
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You ensure that the department's goals are strategically aligned with the company's goals.
You understand how to strategically grow the business and increase customers.
You let employees know how their roles contribute toward the achievement of strategic company objectives.
You strategically align projects to the goals of the company.
You allocate proper resources for employee training to meet future needs based on insight into employee skill levels.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I prioritize tasks and allocate resources.
I schedule staff based on seasonal needs.
You accomplish major tasks by breaking them into manageable pieces.
You set up and monitor timeframes and plans
You purchase equipment and software that will be needed in the future.

51. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
52. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
53. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
54. Additional comments, if any for [Participant Name Here]'s assessment.