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

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Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Looks to others for input.
Shares past experiences with others as learning opportunities.
Seeks feedback to enhance performance.
Open to the suggestions of others.
Actively seeks feedback from others.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is gracious and professional in their interactions with others.
Builds open and trusting relationships.
Treats all people fairly and with respect.
Shows by their actions that they trust in the positive intentions of others.
Works to eliminate unnecessary work or barriers that get in others' way.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses strengths and weaknesses of various quality initiatives.
Implements standardized and data driven quality processes/procedures.
Verifies the correct materials were used in the installation.
Sets benchmarks for quality improvements.
Quickly addresses changes in quality of the products.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets challenging goals.
Eliminates bureaucratic barriers to streamline processes.
Takes calculated risks.
Increased revenue for the company.
Completes work promptly and efficiently.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Ensures compliance with safety regulations.
Develops a sustainable safety culture.
Is aware of OSHA safety guidelines.
Ensures that all supervisors are aware of regulatory and compliance measures.
Participates in safety training as applicable.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages team members to express their ideas and concerns openly.
Identifies the root cause of the problems.
Able to settle disputes equitably.
Seeks to reduce the scarcity of limited resources by sourcing materials from new locations.
Steers the process towards compromise and conflict resolution.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops strategies that are practical and can be feasibly implemented within a reasonable period of time.
Develops a strategic vision for the future.
Focuses efforts on specific marketing strategies.
Undertakes a SWOT analysis to determine the best strategy to move forward.
Looks for opportunities to enhance contributions to the bottom line.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Can work effectively in an environment of uncertainty.
Takes the initiative to complete tasks.
Has a strategic awareness on how to promote the organization.
Is comfortable operating in an environment of uncertainty.
Able to adapt the department to changing business demands and climate.

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.