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
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Adapts to diversity within the team.
Adapts to changes in team membership.
Is open to change and adjusts plans when needed.
Works effectively in dynamic and changing work environments.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Consciously controls own negative emotions in order to keep team morale up.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is open minded and curious about learning new skills.
Inspires others to learn new things.
Holds self and associates accountable for goal achievement.
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
Communicates effectively with others.
Persuades others to consider alternative points of view.
Able to express own goals and needs.
Develops a good rapport with others.
Ensures stakeholders are involved in the decision making process.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Set high standards in their performance
Follows-up and takes action when goals are not met to ensure better results in the future.
Completes work promptly and efficiently.
Strives to meet goals and objectives.
Systematically works to improve the organization
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Performs regular risk analyses to minimize adverse outcomes.
Creates a risk management strategy for the department.
Responds appropriately to unexplained or unanticipated events.
Accurately perceives potential risks in the workplace.
Recognizes that small changes may snowball into major events.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is trusted by peers and co-workers; others are willing to confide in him/her
Able to work with individuals at all levels of the Company.
Uses tact, compassion, and sensitivity in interactions with others.
Anticipates the concerns of other employees.
Provides constructive feedback in a way that fosters acceptance and development.
Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Effectively troubleshoots client issues.
Keeps the client informed of all progress.
Is committed to resolving client issues in a positive way.
Meets with clients on a regular basis.
Responsive to client needs.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Set clear goals for assignments.
Ensures employees understand what is being assigned to them.
Willing to share in the decision making process.
Trusts employees are able to complete assigned tasks.
Is aware of the skill levels of employees and assigns tasks that are at the appropriate skill level.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Regularly makes plans for contingencies.
Able to balance the needs of multiple stakeholders in developing the plan for the division.
Involves relevant coworkers in the development of the plan.
Determines what supplies/equipment will be needed for the job.
Creates to-do lists to make sure nothing is missed.

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.