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

Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Coordinates all department activities into a cohesive team effort.
Able to focus on a task even when working alone.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Takes immediate action toward goals.
Committed to the team.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Documents performance goals through an individual development plan.
Regularly completes tasks on time.
Acknowledges errors and takes the steps necessary to rectify them.
Exhibits a sense of ownership of outcomes and results.
Defines roles, rights, and responsibilities of employees.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses current capabilities before committing to new requests from customers.
Coordinates the work of a team by assigning tasks to other team members.
Keeps track of multiple assignments and deadlines.
Plans and organizes continuously while performing all other responsibilities and activities.
Is aware of the deadlines for specific tasks/assignments.
Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works with other team members to identify bottle necks in the production process.
Contributes to and supports team decision-making process
Creates a culture that fosters and values collaboration.
Helps the team balance analysis with decisiveness in making decisions.
Promotes open communication on the team.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates honesty and truthfulness at all times.
Demonstrates sincerity in actions with others.
Fosters an environment built upon trust.
Maintains strong relationships with others.
Follows tasks to completion.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Actively seeks feedback from others.
Accepts the views of others.
Seeks feedback to enhance performance.
Looks to others for input.
Is visible and approachable.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understands how to meet regulatory compliance.
Uses financial data to mitigate financial risks.
Works effectively to transfers risk.
Uses risk management to remain in compliance with regulations.
Minimizes the increase in costs due to global events or supply chain issues.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Performs work safely.
Is not afraid to question a potential safety issue observed in the workplace.
Encourages others to work safely.
Seeks to reduce the likelihood of accidents.
Develops a sustainable safety culture.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is honest in all communication with the customers.
Puts customer's needs first.
Helps customers feel they are receiving services tailored specifically to their needs.
Provides excellent service to customers.
Responds to feedback from customers.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Attends [Company] gatherings and social events.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].

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.