Empowering Others- 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

Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to share in the decision making process.
Demonstrates confidence in the abilities of subordinates.
Ensures employees understand what is being assigned to them.
Distributes the workload to subordinates.
Is aware of the skill levels of employees and assigns tasks that are at the appropriate skill level.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helpful
Works effectively with people from other departments.
Supports the efforts of other employees in implementing solutions to problems.
...treats others with respect and dignity.
Able to see issues from others' perspectives.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works to eliminate unnecessary work or barriers that get in others' way.
Contributes to a positive and fun work environment.
Contributes to a positive work environment.
Builds open and trusting relationships.
Is gracious and professional in their interactions with others.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Takes responsibility for things that go wrong
Is ready to offer help
Sets an example for others to follow
Keep staff informed about what is happening in the company
Supervisory Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Enhances teamwork through good supervision.
Provides direction and coaching to employees.
Listens to others.
Provides clear expectations of outcomes during performance reviews.
Treats all staff equitably.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Conducts timely follow-up; keeps others informed on a need to know basis.
Sets high expectations and goals; encourages others to support the organization.
Makes sure that I have a clear idea of our group's goals.
Achieves established goals.
Establishes and documents goals and objectives.
Clarity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Clearly explains responsibilities to individuals.
Is clear about goals that need to be achieved.
Is clear about the roles and duties of team members.
Clarifies problems and their causes to help employees correct them.
Communicates with clarity and efficiency.
Global Perspective	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Sets the example for team on importance of cultural awareness.
Aligns personal vision with global strategies.
Is able to work with individuals having different backgrounds and cultures.
Works well with others from different cultural backgrounds.

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

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

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