Delegation - 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

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Delegation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets clear and reasonable expectations for others and follows through on their progress.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
Defines the roles, responsibilities, required actions, and deadlines for team members.
Entrusts subordinates with important tasks.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Decides which long-term goals should be met.
Examines relevant factors needed to make a decision.
Seeks input from key people who should be involved in, or will be affected by, decisions
Effectively chooses appropriate courses of action.
Acts confidently in the absence of guidance.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops and maintains quality control checklists for the manufacturing department.
Assesses strengths and weaknesses of various quality initiatives.
Verifies the operators have the necessary equipment and supplies to ensure high quality.
Provides regular and timely feedback on quality levels.
Positively influences others to strive to attain high quality standards.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Achieves high levels of performance.
Sets benchmarks and milestones to measure progress toward the objectives.
Is a high achiever.
Concentrates efforts on the most urgent needs.
Stays focused on solving problems and getting work done.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Comes across as credible, knowledgeable and sincere
Is willing to lend a hand to those in the department who need help.
Assists those in the department who need help in meeting performance metrics.
Anticipates the concerns of other employees.
Attends to both the content and the context of what was being said.
Adaptability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is aware of changes to team personnel.
Adjusts strategy when new information is presented.
Effective in working with different personnel of the team.
Responds quickly to new information.
Is open to changes in policies and procedures.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Functions well under stress, deadlines, and/or significant workloads.
Stays focused even when under pressure and stress.
Maintains focus when handling several problems or tasks simultaneously.
Sets appropriate goals for employees.
Makes sure that employees understand how their work relates to organizational goals.
Managing Performance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets long and short term goals.
Holds the team leader accountable for the team meeting key performance responsibilities.
Conducts objectives and key results (OKR) assessments on a quarterly basis.
Ensures employees are trained in areas where performance may be lacking.
Obtains commitment from employees regarding completion of tasks.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Allows employees to make their own decisions.
Permits employees to take training to become more independent.
Fosters a sense of ownership and accountability for the process/product.
Gives employees the freedom to set their own schedule.
Gives responsibility for making important decisions to employees.
Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to accurately paraphrase and summarize what other team members have said.
Works with other team members to achieve objectives.
Builds relationships across boundaries and with key stakeholders by developing informal and formal networks.
Fosters an environment that promotes active listening on the team.
Creates opportunities to learn with other team members

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.