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 can be counted on to do what you say you are going to do.
You continue to work diligently on a problem despite setbacks.
You consistently strive to complete work on time or ahead of schedule.
I accept personal responsibility for producing high quality and timely work.
You keep you supervisor informed of recent events.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are open minded and curious about learning new skills.
You enhance your value to the company through additional training and development.
You stay up-to-date on emerging technologies.
You enjoy learning new skills and techniques.
You are open to feedback from others.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are excellent at managing time.
You make sure that employees understand and identify with the team's mission.
You function well under stress, deadlines, and/or significant workloads.
You set appropriate goals for employees.
You help guide employees with prioritizing tasks.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You ensure stakeholders are involved in the decision making process.
You understand what others need.
You persuade others to consider alternative points of view.
You seek to obtain consensus or compromise.
You communicate effectively with others.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You offer solutions to problems when talking with clients.
I encourage innovation from all levels of employees.
You use unconventional approaches to solve problems.
I show flexibility and willingness to adapt to new approaches and changing market conditions.
I empower employees with the technical skills essential for driving innovation and achieving strategic goals.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You complete work to given time frame and to budget
You demonstrate a sense of urgency to quickly and accurately solve problems and issues.
You inspire others to work with a sense of urgency.
You rapidly complete tasks and assignments.
You are flexible in adjusting priorities to meet the demands of changing situations.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to work with individuals at all levels of the company.
You are a role model for others demonstrating the importance of interpersonal skills.
You adapt management style to meet the needs of the individual or situation.
I value the input from coworkers.
You demonstrate good communication with colleagues and customers.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You give others development opportunities through project assignments and increased job responsibilities
You work to identify root causes of performance problems
You take immediate action on poor performance
You adapt coaching and mentoring approach to meet the style or needs of individuals
You provide ongoing feedback to co-workers on your development progress
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I attend industry conferences to gain further insight into how other companies deal with similar issues.
I observe employees at work to get better insight into the issues they are dealing with.
You ensure that the department's goals are strategically aligned with the company's goals.
You meet with customers to gain insight into their core needs and how best to serve them.
You have conversations with customers and clients to get a better insight into their personal needs.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I divide complex tasks into smaller steps to measure progress toward a goal.
You ensure that everyone in the department is onboard with the current plan.
I set the appropriate sequence of tasks to ensure completion of the project.
I plan for how to allocate time to specific activities.
I prioritize plans based on a cost/benefit analysis.

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.