Excellence - 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

Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Can be counted on to add value wherever they are involved.
Is planful and organized.
Demonstrates the functional or technical skills necessary to do their job.
Keeps themselves and others focused on constant improvement.
Produces high quality work.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to adapt to new situations.
Works effectively during periods of change.
Open to the perspectives/viewpoints of others.
Is open to alternative ways to accomplish goals
Encourages others to adopt new procedures.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Pursues professional development opportunities when they arise.
Sets relevant learning objectives and goals.
Builds on their strengths while addressing their weaknesses.
Takes the initiative to learn new skills.
Participates in regular training offered.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Contributes to a positive and fun work environment.
Builds open and trusting relationships.
Works to eliminate unnecessary work or barriers that get in others' way.
Contributes to a positive work environment.
Shows by their actions that they trust in the positive intentions of others.
Managing Performance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets specific and measurable goals for others and follows through to completion.
Obtains commitment from employees regarding completion of tasks.
Sets and maintains high standards for self and others.
Recognizes and values good performance.
Provides employees with necessary resources to accomplish their goals.
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to develop, justify and present a budget.
Has strong technical/computer skills.
Accurately implements contract provisions.
Implements and uses performance measures.
Takes responsibility for decisions.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure that team members have a clear idea of our group's goals.
Sets high expectations and goals; encourages others to support the organization.
Achieves established goals.
Understands & contributes to development of strategic goals.
Makes sure that I have a clear idea of our group's goals.
Clarity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure goals and objectives are clearly and thoroughly explained and understood.
Avoids creating ambiguity or mixed messages.
Communicates ideas and facts clearly and effectively in writing.
Attends to the important details of a job or task.
Clarifies problems and their causes to help employees correct them.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Committed to safety in the workplace.
Encourages others to work safely.
Mitigates hazards and safety issues that arise.
Develops safety guidelines for the department.
Supports safety programs and procedures.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works in an organized manner
Anticipates obstacles and ways to overcome them.
Delegates role to team members to accomplish goals.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Able to look ahead (beyond the present) when addressing the work/needs of the department.

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

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

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