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

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Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Coordinates the knowledge, skills and resources of others to accomplish more in the department.
Enables employees to take on more challenging roles.
Creates a culture where employees are given the opportunity to take the initiative and make impactful decisions.
Recognizes the contributions that others make to the department.
Allows employees to take ownership of their work.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works across boundaries within the organization.
...treats others with respect and dignity.
Is able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Constructively receives criticism and suggestions from others.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understands value of time and does not waste the time of others.
Shows empathy in their interactions with others.
Listens actively to others without interrupting or dismissing their contributions.
Shows genuine interest in the well-being of colleagues, beyond work performance.
Models a growth mindset by sharing what they're learning in real time.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses risks to drive effective decision-making.
Monitors progress on delegated tasks and provides timely support or redirection when needed.
Incorporates input from relevant stakeholders when determining resource needs and priorities.
Uses discipline as a tool for growth, focusing on feedback and learning rather than punishment.
Keeps essential assignments on track and completed within required timeframes.
Supervisory Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works well with the team members.
Addresses performance issues with a developmental mindset, emphasizing improvement over retribution.
Empowers employees to perform the assigned tasks.
Determines the training and development needs of employees and staff.
Fosters a positive work environment in the department.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines goals on a path of ongoing improvement.
Establishes a clear link between shorter, task-specific goals and overarching, long-term performance goals.
Focuses on actions that actively contribute to achieving the goal.
Provides the necessary resources and guidance for employees to achieve their goals.
Keeps track on performance of goals and makes adjustments as needed.
Clarity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is clear about goals that need to be achieved.
Adjusts communication methods to the needs of the audience.
Checks details thoroughly.
Writes clear job descriptions for positions in the organization.
Makes sure employees understand why they were given certain assignments.
Global Perspective	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Applies knowledge of overseas markets.
Has positive interactions with individuals from different cultures and backgrounds.
Able to work with others from different cultures and countries.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Able to listen and understand others and discuss issues in a respectful way.

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.