Achievement - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve 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 and discussed with the employee to foster growth and on-going development.

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

Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets challenging goals.
Demonstrates a well-organized and timely approach to achieve desired results
Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.
Works at a quick pace to complete a high volume of work.
Takes calculated risks to achieve higher levels of performance.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps others when free-time is available.
Explains the "whys" behind organizational objectives
Inspires and motivates co-workers to be productive and energetic at work
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Does not become distracted by non-issues or interruptions.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Able to deliver presentations.
Communicates with department leadership
Asks follow-up questions as needed.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Can be counted on to do what they say they are going to do.
Creates a consistent process for prioritizing work.
Encourages employees to take on greater responsibilities.
Takes responsibility for results.
Develops goals and establishes objective measures of success.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains strong relationships with others.
Fosters an environment built upon trust.
Demonstrates honesty and truthfulness at all times.
Follows tasks to completion.
Establishes relationships of trust, honesty, fairness, and integrity.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Sets an example for others to follow
Is ready to offer help
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Always strives to produce the highest quality work products.
Corrects issues in a timely manner.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Reflects on what is working and what could be improved.
Encourages employees to produce the best quality products.
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports technical training and development of employees.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Proficient in the use of technical systems and processes.
Understands and is committed to implementing new technologies.
Adopts the implementation of new technology into the workplace.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops policies to address risk situations in the workplace.
Is concerned about process safety management.
Seeks to increase safety in the workplace.
Committed to implementing rules and procedures to minimize risk.
Tracks risks in a project.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is a person you can trust.
Responsible for setting the vision of the department.
Sets a good example.
Acts as a resource without removing individual responsibility.
Sets a good example
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Says "thank you" to show appreciation for work of others.
Finds opportunities to recognize others.
Recognizes team members who offer a significant contribution to a project.
Reinforces and rewards employees for accomplishing necessary goals.
Readily shares credit and gives others opportunity for visibility.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has a strategic awareness on how to promote the organization.
Seeks and utilizes mentors to help guide professional development.
Balances risks and rewards when making decisions.
Maintains a high level of energy to respond to demands of the job.
Devotes a certain amount of time and effort to developing new business opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Adept at navigating within the culture of the department.
Gets things done through the department.
Anticipates problems that may affect the department.
Able to use corporate politics to advance department objectives.
Effective in communicating with others within the organization.

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

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

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