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
Contributes to a positive work environment.
Is gracious and professional in their interactions with others.
Contributes to a positive and fun work environment.
Visibly supports and encourages diversity in style and background.
Works to eliminate unnecessary work or barriers that get in others' way.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes charge of addressing and solving problems.
Provides clear reasons for underperformance.
Acknowledges errors and takes the steps necessary to rectify them.
Lets supervisor know of any setbacks to the progress on achieving goals.
Sets clear performance measures.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does what was promised.
Maintains strong relationships with others.
Accepts responsibility for mistakes.
Fosters a high standard of ethics and integrity.
Protects the integrity and confidentiality of information
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Responds to requests for information in a timely manner.
Conducts appointments at scheduled start time.
Avoids making personal phone calls during working hours.
Invoices clients on a timely basis.
Starts meetings on time.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Facilitates change with minimal resistance.
Works cooperatively with others to implement changes.
Develops a strategy for implementing changes.
Adopts changes to set and example for others to follow.
Able to get team members to change their attitudes.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Points out behaviors in others that may be unsafe.
Committed to safety in the workplace.
Develops safety guidelines for the department.
Identifies and addresses safety needs.
Performs work safely.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Holds herself / himself accountable to goals / objectives
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Sets high personal standards of performance.
Sets a good example.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Addresses contentious issues earlier rather than later.
Able to persuade and influence others.
Attempts to accommodate vital interests of those who felt alienated or suffered injustice.
Avoids conflicts over minor issues.
Seeks to remove misperceptions that may contribute toward conflict.

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.