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

Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You define roles, rights, and responsibilities of the team.
You develop goals and establishes objective measures of success.
You are someone who is trustworthy.
You create a consistent process for prioritizing work.
You take responsibility for results.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate through personal behavior the commitment to high standards of performance.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
You actively seek to learn by asking questions and listening to all store associates.
You critique own performance and learn from experience as a source of continuous improvement.
You persist until goals are achieved and commitments are met.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are excellent at managing time.
You maintain self-control when personally criticized.
You make sure that employees understand how their work relates to organizational goals.
You help guide employees with prioritizing tasks.
You maintain focus when handling several problems or tasks simultaneously.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop a good rapport with others.
You seek to obtain consensus or compromise.
You ensure stakeholders are involved in the decision making process.
You have excellent influencing/negotiating skills.
You persuade others to consider alternative points of view.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You analyze current procedures and identify opportunities for improvement.
You build upon the ideas and solutions of others.
You offer constructive improvements to existing systems.
You suggest new ideas at meetings.
You challenge current procedures to develop other alternatives.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You follow-up and take action when goals are not met to ensure better results in the future.
You systematically work to improve the organization
You set high standards in your performance
You accept setbacks and challenges as improvement opportunities
You make a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You provide constructive feedback in a way that fosters acceptance and development.
You use tact, compassion, and sensitivity in interactions with others.
You create an atmosphere that supports the open expression of ideas
You use knowledge and charisma rather than position, power, or coercion to influence others
You value the opinions of others.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take immediate action on poor performance
You provide ongoing feedback to co-workers on your development progress
You adapt coaching and mentoring approach to meet the style or needs of individuals
You give others development opportunities through project assignments and increased job responsibilities
You set and clearly communicate expectations, performance goals, and measurements to others
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You communicate vision for the department and company.
You identify root causes of problems.
You identify potential problems before they become critical incidents.
You analyze records and reports to obtain insight into potential issues and trends.
You formulate strategies and action plans to ensure successful completion of goals and objectives.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
You delegate role to team members to accomplish goals.
You are able to identify the needs of the department before a major change.
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
You anticipate obstacles and ways to overcome them.

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.