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 current job responsibilities.
Looks for ways to expand and learn new job skills.
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
Analyzes processes to determine areas for improvement.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains an efficient schedule of activities.
Starts meetings on time.
Responds to requests for information in a timely manner.
Arrives to meetings on time.
Invoices clients on a timely basis.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Can be counted on to do what they say they are going to do.
Tackles issues head on and finds solutions.
Is someone you can trust.
Defines roles, rights, and responsibilities of the team.
Encourages employees to take on greater responsibilities.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters an environment built upon trust.
Fosters a high standard of ethics and integrity.
Demonstrates sincerity in actions with others.
Follows tasks to completion.
Accepts responsibility for mistakes.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a strategy for implementing changes.
Supports new initiatives for organizational changes to improve effectiveness.
Supports the Company's efforts to implement changes.
Adopts changes to set and example for others to follow.
Effective in implementing new organizational vision and values.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is aware of process safety management.
Develops policies for risk management.
Rewards innovative experiments to try new ideas.
Tracks and monitors incidents that may increase the risk of adverse consequences.
Performs regular risk analyses to minimize adverse outcomes.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Points out behaviors in others that may be unsafe.
Is aware of OSHA safety guidelines.
Ensures that all supervisors are aware of regulatory and compliance measures.
Commits adequate resources toward safety measures.
Mitigates hazards and safety issues that arise.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Provides clear, motivating, and constructive feedback.
Helps employees to understand responsibilities, authority, and expectations.
Helps employees to maintain high personal standards.
Meets regularly with employees to coach them on areas that will enhance their performance
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Attends [Company] gatherings and social events.
Understands how decisions impact other business units beyond their immediate department of work group.
Follows existing procedures and processes.
Understands the use of [Company] products and services.
Impresses upon others the important aspects of [Company].

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.