Commitment to Result - 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

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Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to do whatever it takes-not afraid to have to put in extra effort.
Coordinates all department activities into a cohesive team effort.
Maintains persistence and dedication to achieving results.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Able to focus on a task even when working alone.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines roles, rights, and responsibilities of the team.
Holds employees accountable through regular performance reviews.
Demonstrates a commitment to taking responsibility for actions.
Consistently strives to complete work on time or ahead of schedule.
Takes responsibility for the direction of the team.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keeps track of multiple assignments and deadlines.
Organizes tasks for the most efficient order of completion.
Completes multiple tasks simultaneously.
Assesses current capabilities before committing to new requests from customers.
Plans and organizes continuously while performing all other responsibilities and activities.
Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Treats other team members with respect.
Creates opportunities to learn with other team members
Coaches team members
Works well with other team members.
Encourages teamwork and collaboration.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does what was promised.
Develops trust and confidence from others.
Follows tasks to completion.
Fosters an environment built upon trust.
Establishes relationships of trust, honesty, fairness, and integrity.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is visible and approachable.
Shares past experiences with others as learning opportunities.
Open to the suggestions of others.
Seeks feedback to enhance performance.
Is easy to approach with ideas and opinions.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Integrates risk management into strategic decision making.
Determines the impact of specific risks on infrastructure.
Bases decisions on patterns found in fluid/changing information.
Creates a risk management strategy for the department.
Recognizes the potential impact of systemic risks.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Seeks to reduce the likelihood of accidents.
Creates accurate and effective measures of safety.
Develops a sustainable safety culture.
Works to implement corrective safety measures.
Points out behaviors in others that may be unsafe.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fulfills commitments made to customers.
Prioritizes the needs and preferences of the customer.
Maintains up-to-date information regarding customer products.
Adapts to changes proposed by the customer.
Attends to the customer's needs in addition to the specific needs of the project.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.

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.