Flexibility - 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

Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages others to adopt new procedures.
Identifies new opportunities to achieve goals
Works effectively during periods of change.
Adapts to new organizational structures, policies, or procedures.
Effective in incorporating new ideas.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Uses patience and self-control in working with customers and associates.
Does not allow own emotions to interfere with the performance of others.
Analyzes interpersonal problems instead of reacting to them.
Steps away from a situation to process appropriate response.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Embraces new technology and procedures.
Exhibits willingness to upgrade skills through additional training and education.
Enjoys learning new skills and techniques.
Stays up-to-date on emerging technologies.
Is committed to enhancing their own knowledge and skills.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keep themselves up-to-date of technical/professional issues
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Quickly acquire and apply new knowledge and skills when needed
Contributing fully to the extent of their skills
Seeks opportunities for continuous learning.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Actively seeks feedback from others.
Asks others for their ideas and opinions.
Seeks feedback to enhance performance.
Open to the suggestions of others.
Is visible and approachable.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure that employees understand and identify with the team's mission.
Functions well under stress, deadlines, and/or significant workloads.
Helps guide employees with prioritizing tasks.
Stays focused even when under pressure and stress.
Sets appropriate goals for employees.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the functional or technical skills necessary to do their job.
Can be counted on to add value wherever they are involved.
Demonstrates the analytical skills to do their job.
Is planful and organized.
Takes a lot of pride in their work.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Successfully resolves conflicts and grievances to a win-win solution.
Honest about owning up to mistakes made.
Maintains a high degree of honesty and integrity.
Responds quickly to inquiries from potential customers.
Is trusted by peers and co-workers; others are willing to confide in him/her
Strategic Insight	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Formulates policies and strategies for addressing the Company's important challenges.
Develops a strategic vision for the future.
Maintains knowledge of current trends in the industry.
Creates a mission statement describing the purpose for the organization.
Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses the potential impact of changes to the strategic plan.
Determines the steps required for completion of a task.
Develops plans used to accomplish urgent or critical tasks.
Develops a detailed plan outlining tasks, resources, timelines, and deliverables.
Has developed an effective strategic plan.

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.