Action - 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

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Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes challenging projects successfully despite setbacks.
Takes steps to prepare for the start of the project.
Looks for extra ways to help the department achieve performance goals.
Uses strategies to stay ahead of potential challenges at work.
Decides to act rather than remain passive.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Enhances value to the company through additional training and development.
Will participate in training classes even if offered outside of normal working hours.
Exhibits willingness to upgrade skills through additional training and education.
Is committed to enhancing their own knowledge and skills.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understanding what others need.
Ensures stakeholders are involved in the decision making process.
Communicates effectively with others.
Persuades others to consider alternative points of view.
Seeks to obtain consensus or compromise.
Performance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has great overall performance
Sets a high standard for job performance.
Able to organize work.
...Overall Performance
Effective in performing his/her job.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Challenges assumptions about the way things work.
Offers innovative solutions to Company problems.
Focuses on creating new value for our products/services.
Focuses innovation on the core products or services offered.
Pursues innovative approaches to the current policies and procedures.
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.
Completed training on the new equipment.
Reduces staff turnover.
Driven to complete goals despite obstacles that may arise.
Holds others to high standards of achievement.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.
Keeps themselves and others focused on constant improvement.
Produces high quality work.
Is planful and organized.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Offers praise to colleagues who have successfully completed major projects.
Uses knowledge and charisma rather than position, power, or coercion to influence others
Is open and approachable
Anticipates the concerns of other employees.
Embraces the differences in individuals that comprise the team.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops the skills and capabilities of others.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Addresses employee behavior problems effectively.
Conducts regular performance appraisals and feedback.
Provides clear, motivating, and constructive feedback.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Creates a decisive, team-oriented environment; clarifies goals; and outlines a strategic agenda.
Effectively sets the tone and agenda, creates rapport, and builds momentum at the start of negotiations.
Identifies tradeable interests that could facilitate reaching a consensus.
Maintains control over emotions to ensure a constructive environment.
Demonstrates emotional stability to facilitate productive problem-solving and relationship building.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has plans to handle unexpected events.
Accurately estimates the duration of tasks.
Regularly makes plans for contingencies.
Open to input from others into the plan for the project.
Determines the amount of materials/supplies needed for the project.

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

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

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