Innovation - 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

Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops new products and services.
Implements best practices within the department.
Encourages open communication to ensure that all proposals are considered.
Fosters a creative and innovative work environment.
Takes risks to advance important ideas.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps others when free-time is available.
Strives to achieve high volume of output.
Achieves high levels of performance.
Prioritizes goals to complete those in urgent need first.
Highly motivated to complete tasks despite obstacles that may arise.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Responds to critical concerns of stakeholders.
Presents clear and persuasive information in reports.
Communicates goals of project, resources required, resources available, etc. to the team
Articulates ideas and emotions clearly to others.
Willing to express their concerns to colleagues.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes responsibility for the direction of the team.
Always starts work on time.
Able to complete required tasks on time and delivered expected results.
Works diligently for the success of the team.
Regularly leads the way when helping the team troubleshoot various issues.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains strong relationships with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Demonstrates sincerity in actions with others.
Fosters a high standard of ethics and integrity.
Protects the integrity and confidentiality of information
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Is ready to offer help
Keep staff informed about what is happening in the company
Takes responsibility for things that go wrong
Sets an example for others to follow
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Acts as a resource without removing individual responsibility.
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Responsible for setting the vision of the department.
Holds herself / himself accountable to goals / objectives
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes people around them feel appreciated and valued.
Is sincerely interested in the suggestions of co-workers
Readily shares credit and gives others opportunity for visibility.
Says "thank you" to show appreciation for work of others.
Recognizes the abilities and skills of self and others
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits determination and passion in completion of goals.
Balances risks and rewards when making decisions.
Excellent at managing relationships with stakeholders.
Devotes a certain amount of time and effort to developing new business opportunities.
Encourages dynamic growth opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Gets things done through the department.
Able to deal with sensitive issues with tact and professionalism.
Understands departmental policies and procedures.
Adept at navigating within the culture of the department.
Able to explain departmental policies and procedures to others.

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.