Continual Improvement - 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

Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Looks for ways to expand and learn new job skills.
Analyzes processes to determine areas for improvement.
Open to the suggestions from others.
Looks for ways to expand current job responsibilities.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Invoices clients on a timely basis.
Conducts appointments at scheduled start time.
Responds to requests for information in a timely manner.
Maintains an efficient schedule of activities.
Starts the workday when scheduled.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accepts responsibility to lead efforts to solving critical problems.
Lets supervisor know of any setbacks to the progress on achieving goals.
Works hard to ensure the success of the department.
Takes full responsibility for project outcomes.
Acts like an owner when they make decisions.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters an environment built upon trust.
Demonstrates sincerity in actions with others.
Develops trust and confidence from others.
Protects the integrity and confidentiality of information
Follows tasks to completion.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports the Company's efforts to implement changes.
Effective in dealing with ambiguous and challenging situations.
Develops plans for following through on the changes.
Inspires others to want to change.
Able to get department employees to accept new changes.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains open communication with other departments.
Establish roles, responsibilities, procedures.
Promotes risk management competence throughout the organization.
Create continuity plans.
Ensures employees are aware of potential impacts by increasing risk visibility.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Performs work safely.
Encourages others to attend safety training.
Works to implement corrective safety measures.
Ensures that all supervisors are aware of regulatory and compliance measures.
Commits adequate resources toward safety measures.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Helps employees to maintain high personal standards.
Conducts regular performance appraisals and feedback.
Addresses employee behavior problems effectively.
Develops the skills and capabilities of others.
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.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.

46. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
47. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
48. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
49. Additional comments, if any for [Participant Name Here]'s assessment.