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
Looks to others for input.
Accepts the views of others.
Actively seeks feedback from others.
Seeks feedback to enhance performance.
Open to the suggestions of others.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is gracious and professional in their interactions with others.
Works to eliminate unnecessary work or barriers that get in others' way.
Builds open and trusting relationships.
Contributes to a positive work environment.
Contributes to a positive and fun work environment.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Analyzes quality improvement plans and initiatives.
Views quality issues as a system failure rather than an individual failure.
Understands and uses established quality procedures/controls.
Develops measures of the success of quality initiatives.
Identifies strategies and their associated risks to improve quality.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes work to given time frame and to budget
Is results oriented.
Establishes stretch goals to advance skills and output.
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Increased production by 20 percent.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports our company's safety programs.
Encourages others to attend safety training.
Ensures compliance with safety regulations.
Performs work safely.
Develops safety guidelines for the department.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Investigates opportunities to achieve mutually beneficial solutions to conflicts.
Works to meet the basic needs of each side in the conflict.
Guides others toward establishing strong relationships.
Prepares team members to accept differing view points.
Helps others to see perceptions that they have about an issue.
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.
Maintains a strategic focus on external factors impacting the success of the company.
Communicates goals and objectives to employees.
Mobilizes change through executive leadership to implement corporate strategies.
Develops a strategic plan to focus on strategic issues.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains a high level of energy to respond to demands of the job.
Has a strategic awareness on how to promote the organization.
Balances risks and rewards when making decisions.
Can work effectively 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.