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
Adjusts plans to meet the needs of new constraints.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Is aware of changes to the policies and procedures.
Works effectively in dynamic and changing work environments.
Adapts to changes in team membership.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Analyzes interpersonal problems instead of reacting to them.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Does not allow own emotions to interfere with the performance of others.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Uses patience and self-control in working with customers and associates.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits willingness to upgrade skills through additional training and education.
Stays up-to-date on emerging technologies.
Is committed to enhancing their own knowledge and skills.
Takes initiative for own learning and development.
Creates an environment that supports personal development and exploration.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Attempts to persuade others rather than simply control them.
Seeks to obtain consensus or compromise.
Ensures stakeholders are involved in the decision making process.
Able to express own goals and needs.
Communicates effectively with others.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes stretch goals to advance skills and output.
Takes calculated risks to achieve significant rewards.
Successfully launched the ABC project.
Sets ambitious standards of performance.
Driven to complete goals despite obstacles that may arise.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Prioritizes risks based on probability of occurrence and possible impact to the company.
Uses actionable data and analytics to improve risk tolerance.
Establish roles, responsibilities, procedures.
Is aware of process safety management.
Communicates the protocols.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Creates an atmosphere that supports the open expression of ideas
Is a highly respected individual in the company.
Demonstrates a high degree of ethics and integrity in the workplace.
Attends to both the content and the context of what was being said.
Gives constructive feedback on performance reviews.
Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Anticipates resources needed to meet the client needs.
Prioritizes the needs and preferences of the client.
Makes client's needs a top priority.
Creates documents that meet the client's specifications.
Responsive to client needs.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Recognizes and rewards employees who make important decisions and take action when necessary.
Fosters a sense of ownership and accountability for the process/product.
Enables team members to make their own decisions on the project.
Provides opportunities for employee development and growth.
Allows employees to organize their schedule to best accomplish the job.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses the potential impact of changes to the strategic plan.
Able to balance the needs of multiple stakeholders in developing the plan for the division.
Determines the steps required for completion of a task.
Develops a detailed plan outlining tasks, resources, timelines, and deliverables.
Determines what supplies/equipment will be needed for the job.

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.