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
Trusts employees with important responsibilities.
Is confident in the abilities of employees assigned important tasks.
Establishes goals that allow employees top operate independently in the field.
Encourages independent, original thinking and creative problem-solving.
Empowers employees to structure their work hours to maximize their productivity.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Consistently demonstrates ability and willingness to trust others.
Forms working relationships with employees from other departments.
Works across boundaries within the organization.
Treats others with respect and dignity.
Works effectively with people from other departments.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Contributes to a positive work environment.
Visibly supports and encourages diversity in style and background.
Builds open and trusting relationships.
Is gracious and professional in their interactions with others.
Contributes to a positive and fun work environment.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Is ready to offer help
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Sets an example for others to follow
Supervisory Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Treats all staff equitably.
Assigns tasks appropriately.
Maintains disciplinary policy and fair enforcement of work rules
Demonstrates exemplary work performance that others should follow.
Encourages employees to take responsibility for mistakes.
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.
Establishes and documents goals and objectives.
Makes sure that team members have a clear idea of our group's goals.
Achieves established goals.
Achieves goals.
Clarity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Clearly explains the vision and goals of the company.
Makes sure goals and objectives are clearly and thoroughly explained and understood.
Clarifies problems and their causes to help employees correct them.
Clearly defines work objectives for employees.
Provides a clear vision for the future.
Global Perspective	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Volunteers for experiences and assignments abroad.
Creates an environment where individual differences are valued and supported.
Considers customers point of view when making decisions.
Collaborates with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.

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.