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.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps guide employees with prioritizing tasks.
Makes sure that employees understand and identify with the team's mission.
Excellent at managing time.
Aligns the department's goals with the goals of the organization.
Functions well under stress, deadlines, and/or significant workloads.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Gives clear and convincing presentations.
Coaches others and provides feedback on the use of different oral communication styles for different audiences
Listens to others' points of view with an open mind
Checks for understanding throughout conversations or group presentations/discussions
Is an effective communicator
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines roles, rights, and responsibilities of employees.
Accepts accountability for their actions and results.
Tackles issues head on and finds solutions.
Takes ownership of mistakes and learns from them.
Keeps supervisor informed of recent events.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Protects the integrity and confidentiality of information
Demonstrates sincerity in actions with others.
Fosters a high standard of ethics and integrity.
Does what was promised.
Demonstrates honesty and truthfulness at all times.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is creative about the decisions they make.
Weighs the pros and cons of decisions.
Asks for additional information when making critical decisions.
Evaluates information before making a final decision.
Examines for patterns in data to help predict future possibilities.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets challenging goals for the department.
Set high standards in their performance
Is determined to complete tasks regardless of obstacles that may occur.
Systematically works to improve the organization
Driven to complete goals despite obstacles that may arise.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Identifies and addresses safety needs.
Participates in safety training as applicable.
Develops a culture of safety.
Encourages others to attend safety training.
Keeps accurate safety records.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is a person you can trust.
...takes personal responsibility for results.
Behavior is ethical and honest.
Sets a good example.
Sets a good example
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to see issues from others' perspectives.
Respects the opinions of other employees.
Works effectively with people from other departments.
Works across boundaries within the organization.
Treats others with respect and dignity.
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Formulates policies and strategies for addressing the Company's important challenges.
Creates strategies that significantly benefit the Company.
Analyzes unique issues or problems impacting the Company.
Identifies root causes of problems.
Analyzes records and reports to obtain insight into potential issues and trends.

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.