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
Willing to do whatever it takes-not afraid to have to put in extra effort.
Able to focus on a task even when working alone.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Coordinates all department activities into a cohesive team effort.
Encourages commitment in others to obtain results.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines roles, rights, and responsibilities of the team.
Takes responsibility for results.
Creates a consistent process for prioritizing work.
Is aware of problems or issues that may affect the organization.
Develops goals and establishes objective measures of success.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Ensures that assignments are prioritized according to the needs of the department/company.
Begins tasks as soon as possible.
Is aware of the deadlines for specific tasks/assignments.
Spends the most time and effort on critical tasks first.
Keeps track of multiple assignments and deadlines.
Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Applies knowledge of team behavior to help achieve organizational goals and objectives.
Act as an effective team player
Relates to all kinds of people tactfully
Willingly share their technical expertise
Communicates a clear message that teamwork and collaboration are expected.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does what was promised.
Fosters a high standard of ethics and integrity.
Follows tasks to completion.
Develops trust and confidence from others.
Establishes relationships of trust, honesty, fairness, and integrity.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accepts the views of others.
Considers other's opinion and suggestions.
Is visible and approachable.
Seeks feedback to enhance performance.
Looks to others for input.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Gathers information regarding potential risks.
Accurately perceives potential risks in the workplace.
Is concerned about process safety management.
Seeks to increase safety in the workplace.
Responds appropriately to unexplained or unanticipated events.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Participates in safety training when available.
Develops safety guidelines for the department.
Seeks to reduce the likelihood of accidents.
Points out behaviors in others that may be unsafe.
Performs work safely.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Meets with customers on a regular basis.
Helps customers feel they are receiving services tailored specifically to their needs.
Is competent in handling customer cases.
Consistently meets customer's needs.
Competent in managing customer projects.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the "basics" as to how [Company] functions/operates.
Understands the use of [Company] products and services.

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.