Bias for Action - 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

Bias for Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Motivates others to achieve or exceed goals
Displays high energy and enthusiasm on consistent basis.
Seeks and utilizes opportunities for continuous learning and self-development.
Conveys a sense of urgency about addressing problems and opportunities
Identifies ways to simplify work processes and reduce cycle times
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes initiative for own learning and development.
Holds self and associates accountable for goal achievement.
Demonstrates through personal behavior the commitment to high standards of performance.
Persists until goals are achieved and commitments are met.
Is motivated by the desire to be "the best".
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Seeks to obtain consensus or compromise.
Communicates effectively with others.
Has excellent influencing/negotiating skills.
Attempts to persuade others rather than simply control them.
Understanding what others need.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages open communication to ensure that all proposals are considered.
Suggests new ideas at meetings.
Analyzes current procedures and identifies opportunities for improvement.
Creates a safe environment for idea-sharing.
Offers constructive improvements to existing systems.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accepts setbacks and challenges as improvement opportunities
Completes work to a high technical standard
Completes work to given time frame and to budget
Demonstrates a well-organized and timely approach to achieve desired results
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keeps themselves and others focused on constant improvement.
Produces high quality work.
Can be counted on to add value wherever they are involved.
Demonstrates the analytical skills to do their job.
Is planful and organized.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Provides constructive feedback in a way that fosters acceptance and development.
Effectively manages conflicts by dealing with them directly and immediately
Strives for win/win solutions
Successfully resolves conflicts and grievances to a win-win solution.
Expresses appreciation of other's work.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes clear communications to avoid misunderstandings.
Able to influence others to accept certain positions.
Able to say "no" when it is essential to maintaining quality and high standards.
Able to adapt to changing situations.
Actively listens to conversations to be able to recall important details later.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to see issues from others' perspectives.
Is able to see issues from others' perspectives.
Works effectively with people from other departments.
Helpful
Treats others with respect and dignity.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Able to identify the needs of the department before a major change.
Anticipates obstacles and ways to overcome them.
Works in an organized manner
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.

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.