Initiative - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 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. A report will be shared with you at the conclusion of this project.

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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Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I analyze the needs of the situation and act before being told to do so.
I act independently to solve pressing needs.
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
I initiate important conversation topics at meetings.
I am proactive and get things done.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain persistence and dedication to achieving results.
You coordinate all department activities into a cohesive team effort.
You are committed to the team.
You are able to focus on a task even when working alone.
You encourage commitment in others to obtain results.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I remove misperceptions that may be contributing to the conflict.
You combine different ideas and viewpoints.
I identify who holds the authority to make decisions.
I ensure that the basic needs of each party are satisfied.
You help others to see perceptions that they have about an issue.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You use patience and self-control in working with customers and associates.
You step away from a situation to process appropriate response.
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You do not allow own emotions to interfere with the performance of others.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set appropriate goals for employees.
You function well under stress, deadlines, and/or significant workloads.
You maintain self-control when personally criticized.
You align the department's goals with the goals of the organization.
You help guide employees with prioritizing tasks.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am able to identify quality issues critical to the organization.
I effectively coordinate with other departments to improve quality.
I regularly measure product specifications to ensure uniformity and quality control.
You are able to create quality initiatives to be implemented organization-wide.
I propose a variety of solutions to address quality needs.
Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work cooperatively with others to solve problems.
I continuously monitor performance after implementing a solution to ensure it remains effective.
I assign the right people with the right skills to the right tasks taking into account experience, expertise, and availability.
I assess whether the proposed solutions are practical and achievable.
I compare the proposed solutions against each other and against any existing solutions to determine which one is likely to yield the best results.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You clearly explain the issues and interests at the start of negotiations.
You are flexible in responses.
I control emotional responses to maintain a productive atmosphere.
You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
I am aware of wht problems need to be solved.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You recognize the abilities and skills of self and others
You find opportunities to recognize others.
You recognize individuals for a specific outstanding achievement.
You recognize team members who offer a significant contribution to a project.
You readily share credit and gives others opportunity for visibility.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take the initiative to complete tasks.
You seek and utilize mentors to help guide your professional development.
You find unique ways to go around barriers to success.
You have a strategic awareness on how to promote the organization.
You are able to adapt the department to changing business demands and climate.

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.