Attitude - 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

Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Treats all people fairly and with respect.
Builds open and trusting relationships.
Is gracious and professional in their interactions with others.
Works to eliminate unnecessary work or barriers that get in others' way.
Shows by their actions that they trust in the positive intentions of others.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Implements and facilitates controls and processes that maintain the integrity of the organization.
Creates a consistent process for prioritizing work.
Holds team accountable to meeting goals.
Defines roles, rights, and responsibilities of the team.
Acts like an owner when they make decisions.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains strong relationships with others.
Follows tasks to completion.
Develops trust and confidence from others.
Does what was promised.
Accepts responsibility for mistakes.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Starts the workday when scheduled.
Avoids making personal phone calls during working hours.
Conducts appointments at scheduled start time.
Maintains an efficient schedule of activities.
Invoices clients on a timely basis.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Addresses organizational and departmental resistance to changes.
Supports the Company's efforts to implement changes.
Effective in dealing with ambiguous and challenging situations.
Assists others in understanding changes to the organization.
Effective in implementing new organizational vision and values.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is not afraid to question a potential safety issue observed in the workplace.
Seeks to reduce the likelihood of accidents.
Identifies and addresses safety needs.
Points out behaviors in others that may be unsafe.
Develops a sustainable safety culture.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works in a way that makes others want to work with her/him.
Sets high personal standards of performance.
Sets a good example
Is a person you can trust.
Responsible for setting the vision of the department.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Discusses conflict situations with supervisor.
Tries to understand others' point of view before making judgments
Helps employees to think through alternative ways to resolve conflict situations.
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.

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

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

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