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
Open to the suggestions of others.
Is easy to approach with ideas and opinions.
Looks to others for input.
Seeks feedback to enhance performance.
Asks others for their ideas and opinions.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Builds open and trusting relationships.
Contributes to a positive and fun work environment.
Works to eliminate unnecessary work or barriers that get in others' way.
Is gracious and professional in their interactions with others.
Treats all people fairly and with respect.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Consistently provides timely, accurate, and reliable information on quality measures.
Adjusts processes or procedures to improve quality results.
Understands and uses established quality procedures/controls.
Addresses barriers to successfully implementing quality standards.
Ensures the hiring of employees that have a quality focus.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Met required benchmarks for the position.
Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.
Reduces staff turnover.
Improved the quality of work on the production line.
Highly motivated to achieve or exceed performance standards.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a culture of safety.
Commits adequate resources toward safety measures.
Participates in safety training when available.
Works to implement corrective safety measures.
Is aware of OSHA safety guidelines.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Strives to ensure that all basic needs are met, resulting in mutual benefits for both parties.
Possesses the necessary skills to manage conflict and relationships.
Persuades individuals to alter their underlying work behaviors which may have led to the conflict.
Attempts to determine the root sources of grievances.
Promotes employee engagement to reduce tensions and negativity, creating an environment where conflicts are easily managed.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops high-level strategic planning models to identify opportunities to improve the company.
Able to decline a poor strategy by proposing alternate strategies.
Creates innovative strategies.
Creates strategic objectives to increase revenue and profit margins.
Makes strategic decisions to optimize the returns on capital investments.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits determination and passion in completion of goals.
Able to adapt the department to changing business demands and climate.
Encourages dynamic growth opportunities.
Excellent at managing relationships with stakeholders.
Is comfortable operating in an environment of uncertainty.

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.