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
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Follows-up and takes action when goals are not met to ensure better results in the future.
Completes work to a high technical standard
Set high standards in their performance
Accepts setbacks and challenges as improvement opportunities
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Explains the "whys" behind organizational objectives
Stays focused on meeting the needs of customers.
Helps others when free-time is available.
Works toward achievement of goals even when confronted with obstacles.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
Communications with department leadership
Communicates effectively with all levels of the organization.
Communicates effectively with colleagues and customers
Checks for understanding throughout conversations or group presentations/discussions
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes responsibility for results.
Defines roles, rights, and responsibilities of the team.
Acts like an owner when they make decisions.
Keeps their word and does what they say they will do.
Holds team accountable to meeting goals.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters an environment built upon trust.
Follows tasks to completion.
Demonstrates sincerity in actions with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Does what was promised.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes you feel enthusiastic about your work
Keep staff informed about what is happening in the company
Sets an example for others to follow
Delegate tasks effectively
Takes responsibility for things that go wrong
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Holds employees accountable for their quality of work.
Encourages others to produce the highest quality work products.
Corrects issues in a timely manner.
Encourages others to achieve high quality standards.
Always strives to produce the highest quality work products.
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understands and is committed to implementing new technologies.
Applies complex rules and regulations to maintain optimal system performance.
Supports technical training and development of employees.
Uses technology in decision making and problem solving.
Maximizes the use of new technology to deliver products and services.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works within constraints of the organization.
Rewards innovative experiments to try new ideas.
Seeks to retain the best and brightest employees.
Maintains open communication with other departments.
Seeks to maintain the long-term viability of the Company.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Responsible for setting the vision of the department.
Behavior is ethical and honest.
Sets a good example
Completes assigned work tasks.
Is a person you can trust.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Lets employees know when they have done well
Makes people around them feel appreciated and valued.
Recognizes team members who offer a significant contribution to a project.
Recognizes individuals for a specific outstanding achievement.
Says "thank you" to show appreciation for work of others.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Devotes a certain amount of time and effort to developing new business opportunities.
Excellent at managing relationships with stakeholders.
Has a strategic awareness on how to promote the organization.
Exhibits determination and passion in completion of goals.
Finds unique ways to go around barriers to success.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to explain departmental policies and procedures to others.
Able to deal with sensitive issues with tact and professionalism.
Anticipates problems that may affect the department.
Understands departmental policies and procedures.
Able to use corporate politics to advance department objectives.

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.