Adaptability - 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

Adaptability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Able to work effectively with new people and new teams.
Works effectively in dynamic and changing work environments.
Develops insights and applies innovative solutions to projects and problems.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Uses patience and self-control in working with customers and associates.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Steps away from a situation to process appropriate response.
Consciously controls own negative emotions in order to keep team morale up.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates through personal behavior the commitment to high standards of performance.
Is motivated by the desire to be "the best".
Takes initiative for own learning and development.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Holds self and associates accountable for goal achievement.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Persuades others to consider alternative points of view.
Develops a good rapport with others.
Seeks to obtain consensus or compromise.
Attempts to persuade others rather than simply control them.
Has excellent influencing/negotiating skills.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Completes work to a high technical standard
Demonstrates a well-organized and timely approach to achieve desired results
Accepts setbacks and challenges as improvement opportunities
Completes work to given time frame and to budget
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Seeks to maintain the long-term viability of the Company.
Bases decisions on patterns found in fluid/changing information.
Rewards innovative experiments to try new ideas.
Knows how to obtain desired results with minimal losses.
Effectively responds to critical situations to reduce potential for losses.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Expresses appreciation of other's work.
Anticipates the concerns of other employees.
Uses knowledge and charisma rather than position, power, or coercion to influence others
Applies appropriate communication techniques to the situation.
Demonstrates willingness to work with others.
Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Satisfies client needs.
Obtains feedback to ensure client needs are being met.
Forms strong client relationships
Is pro-active in dealing with clients and addressing their needs.
Looks for opportunities that have a positive impact on Clients.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets clear goals for others to accomplish.
Distributes the workload to subordinates.
Provides support and resources needed to accomplish goals.
Allows individuals to be responsible for their decisions.
Avoids micromanaging their employees.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to identify the needs of the department before a major change.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Makes plans and follows through.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Anticipates 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.