Establishing Focus/Direction - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 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. A report will be shared with you at the conclusion of this project.

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

Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You function well under stress, deadlines, and/or significant workloads.
You are excellent at managing time.
You stay focused even when under pressure and stress.
You maintain self-control when personally criticized.
You set appropriate goals for employees.
Objectives	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work toward achieving established goals and objectives.
You establish goals and objectives.
You consistently provide me with timely feedback for improving my performance.
You effectively organize resources and plans
You are able to establish realistic goals.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt coaching and mentoring approach to meet the style or needs of individuals
You provide ongoing feedback to co-workers on your development progress
You take immediate action on poor performance
You set and clearly communicate expectations, performance goals, and measurements to others
You work to identify root causes of performance problems
Business Acumen	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand complex issues and problems.
You consider impact of actions on other areas of the organization.
You are able to align resources to meet the business needs of the company.
You apply the knowledge of work processes to influence the achievement of business goals
You ask the 'right' questions to size up or evaluate situations.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You follow existing procedures and processes.
You express loyalty and dedication to [Company] in interactions with others.
You understand the use of [Company] products and services.
You attend [Company] gatherings and social events.
You understand the "basics" as to how [Company] functions/operates.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You delegate role to team members to accomplish goals.
You anticipate obstacles and ways to overcome them.
You are able to identify the needs of the department before a major change.
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
You make plans and follows through.
Global Perspective	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand how cultures differ and how these differences impact work behavior.
You form strong client relationships with international partners.
You apply knowledge of overseas markets.
You set the example for team on importance of cultural awareness.
You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.

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

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

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