Continual Improvement - 360 Degree Feedback Survey Sample #6

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 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 and . 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 improve work processes and procedures.
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
Looks for ways to expand and learn new job skills.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains an efficient schedule of activities.
Conducts appointments at scheduled start time.
Responds to requests for information in a timely manner.
Starts meetings on time.
Arrives to meetings on time.
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.
Implements and facilitates controls and processes that maintain the integrity of the organization.
Takes ownership of mistakes and learns from them.
Develops goals and establishes objective measures of success.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes relationships of trust, honesty, fairness, and integrity.
Fosters an environment built upon trust.
Develops trust and confidence from others.
Protects the integrity and confidentiality of information
Fosters a high standard of ethics and integrity.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports new initiatives for organizational changes to improve effectiveness.
Works cooperatively with others to implement changes.
Addresses organizational and departmental resistance to changes.
Supports the Company's efforts to implement changes.
Effective in implementing new organizational vision and values.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Rewards innovative experiments to try new ideas.
Seeks to retain the best and brightest employees.
Bases decisions on patterns found in fluid/changing information.
Seeks to maintain the long-term viability of the Company.
Knows how to obtain desired results with minimal losses.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keeps accurate safety records.
Mitigates hazards and safety issues that arise.
Develops safety guidelines for the department.
Ensures compliance with safety regulations.
Encourages others to attend safety training.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Conducts regular performance appraisals and feedback.
Provides clear, motivating, and constructive feedback.
Helps employees to maintain high personal standards.
Helps employees to understand responsibilities, authority, and expectations.
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].
Understands how decisions impact other business units beyond their immediate department of work group.
Attends [Company] gatherings and social events.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.

46. Overall, please rate the effectiveness of .
    

    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 's assessment.