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.
Works to eliminate unnecessary work or barriers that get in others' way.
Contributes to a positive and fun work environment.
Visibly supports and encourages diversity in style and background.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines roles, rights, and responsibilities of the team.
Accepts accountability for their actions and results.
Is aware of problems or issues that may affect the organization.
Can be counted on to do what they say they are going to do.
Develops goals and establishes objective measures of success.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains strong relationships with others.
Demonstrates honesty and truthfulness at all times.
Develops trust and confidence from others.
Protects the integrity and confidentiality of information
Does what was promised.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Starts meetings on time.
Arrives to meetings on time.
Avoids making personal phone calls during working hours.
Responds to requests for information in a timely manner.
Invoices clients on a timely basis.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is an inspiration for others to accept the recent changes.
Able to get department employees to accept new changes.
Able to get team members to change their attitudes.
Works cooperatively with others to implement changes.
Inspires others to want to change.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a culture of safety.
Identifies and addresses safety needs.
Is not afraid to question a potential safety issue observed in the workplace.
Participates in safety training as applicable.
Creates accurate and effective measures of safety.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets high personal standards of performance.
Responsible for setting the vision of the department.
Acts as a resource without removing individual responsibility.
Sets a good example.
Completes assigned work tasks.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Tries to understand others' point of view before making judgments
Identifies and takes steps to prevent potential confrontations.
Helps employees to think through alternative ways to resolve conflict situations.
Deals effectively with employee grievances.
Clearly expresses expectations to others.

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.