Feedback - 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

Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Considers other's opinion and suggestions.
Seeks feedback to enhance performance.
Accepts the views of others.
Asks others for their ideas and opinions.
Is easy to approach with ideas and opinions.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Builds open and trusting relationships.
Works to eliminate unnecessary work or barriers that get in others' way.
Treats all people fairly and with respect.
Visibly supports and encourages diversity in style and background.
Contributes to a positive and fun work environment.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Corrects issues in a timely manner.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Always strives to produce the highest quality work products.
Holds employees accountable for their quality of work.
Encourages others to achieve high quality standards.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes work to a high technical standard
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Completes work to given time frame and to budget
Accepts setbacks and challenges as improvement opportunities
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is not afraid to question a potential safety issue observed in the workplace.
Develops a strong safety culture.
Participates in safety training when offered.
Encourages others to attend safety training.
Performs work safely.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Tries to understand others' point of view before making judgments
Clearly expresses expectations to others.
Deals effectively with employee grievances.
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Able to decline a poor strategy by proposing alternate strategies.
Communicates goals and objectives to employees.
Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
Understands & contributes to development of strategic goals.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits determination and passion in completion of goals.
Encourages risk taking for developing potential business opportunities.
Has a strategic awareness on how to promote the organization.
Encourages dynamic growth opportunities.
Devotes a certain amount of time and effort to developing new business opportunities.

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.