Emotional Intelligence - 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

Emotional Intelligence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accurately perceives the emotional reactions of others.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Able to understand others' points of view.
Is able to control their own emotions.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure that employees understand and identify with the team's mission.
Makes sure that employees understand how their work relates to organizational goals.
Maintains focus when handling several problems or tasks simultaneously.
Maintains self-control when personally criticized.
Stays focused even when under pressure and stress.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Ready to offer feedback, even if it involves tough critiques.
Considers the audience in how the communication is presented.
Produces written content that is both succinct and orderly.
Conveys ideas confidently and succinctly.
Presents issues, ideas, and strategy concisely and clearly.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works diligently for the success of the team.
Expects employees to accept the consequences of their actions.
Consistently exhibits professionalism in interactions with employees.
Requires employees to submit monthly reports of the work they performed.
Takes responsibility for errors in the production line.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Follows tasks to completion.
Does what was promised.
Demonstrates honesty and truthfulness at all times.
Accepts responsibility for mistakes.
Fosters a high standard of ethics and integrity.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Learns from previous bad decisions and rarely repeats them.
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Determines the costs and potential benefits of decisions.
Is confident in the decisions they make.
Is aware of the impact of decisions and informs others about potential outcomes.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Strives to exceed standards of performance.
Follows-up and takes action when goals are not met to ensure better results in the future.
Strives to meet goals and objectives.
Establishes stretch goals to advance skills and output.
Sets challenging goals for the department.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages others to work safely.
Seeks to reduce the likelihood of accidents.
Identifies and addresses safety needs.
Creates accurate and effective measures of safety.
Develops a culture of safety.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
...takes personal responsibility for results.
Acts as a resource without removing individual responsibility.
Sets high personal standards of performance.
Sets a good example
Sets a good example.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Treats others with respect and dignity.
Forms working relationships with employees from other departments.
Works effectively with people from other departments.
Is able to see issues from others' perspectives.
Supports the efforts of other employees in implementing solutions to problems.
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Analyzes records and reports to obtain insight into potential issues and trends.
Creates a vision for the organization based on insights gathered from other companies in the industry.
Identifies root causes of problems.
Analyzes unique issues or problems impacting the Company.
Pursues strategic alliances with valued partners.

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

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

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