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

Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are an inspiration for others to perform above expectations.
When working on a problem in a team, I often am the first to suggest possible solutions.
I anticipate problems and initiate plans to address them.
You confront problems immediately without supervisor instructions.
You initiate actions that impact the department/company.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You coordinate all department activities into a cohesive team effort.
You encourage commitment in others to obtain results.
You are committed to the team.
You maintain persistence and dedication to achieving results.
You create a sense of urgency among the store team members to complete activities, which drive sales.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You help others to see perceptions that they have about an issue.
You deal effectively with employee grievances.
I attempt to determine the root sources of grievances.
You reframe conflicts as opportunities to innovate and create new solutions to problems.
You are open and honest to avoid misunderstandings.
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 set an example for associates during stressful periods by maintaining a positive, can-do attitude.
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 analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You function well under stress, deadlines, and/or significant workloads.
You make sure that employees understand and identify with the team's mission.
You maintain self-control when personally criticized.
You are excellent at managing time.
You stay focused even when under pressure and stress.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You reflect on what is working and what could be improved.
You develop processes to enhance quality standards.
You correct issues in a timely manner.
You present quality information and data in an easy to understand format.
You create effective policies regarding quality of services and products.
Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You generate alternative solutions to problems and challenges.
You identify and assess all potential responses to a problem.
You are able to solve problems at root cause rather than at symptom level.
You solve problems using logic and insight.
You understand the root causes of problems.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am able to collaborate with others in solving problems to create solutions that satisfy both parties' interests.
I identify tradeable interests that could facilitate reaching a consensus.
You take steps to control emotional responses to avoid making rash decisions.
I am a proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
I establish a strong, cooperative atmosphere; defines expectations; and presents a well-structured agenda aligned with key priorities.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You find opportunities to recognize others.
You say "thank you" to show appreciation for work of others.
You recognize individuals for a specific outstanding achievement.
You compliment other people when they do good work
You make people around them feel appreciated and valued.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage risk taking for developing potential business opportunities.
You have a strategic awareness on how to promote the organization.
You encourage dynamic growth opportunities.
You seek and utilize mentors to help guide your professional development.
You find unique ways to go around barriers to success.

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.