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
Encourages open communication to ensure that all proposals are considered.
Creates a safe environment for idea-sharing.
Analyzes current procedures and identifies opportunities for improvement.
Suggests new ideas at meetings.
Offers constructive improvements to existing systems.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Directs team in prioritizing daily work activities
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Explains the "whys" behind organizational objectives
Inspires and motivates co-workers to be productive and energetic at work
Does not become distracted by non-issues or interruptions.
Communication Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to deliver presentations.
Is an effective communicator
Able to demonstrate persuasiveness in pursuit of objectives.
Coaches others and provides feedback on the use of different oral communication styles for different audiences
Addresses issues of key importance to stakeholders.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes responsibility for results.
Acts like an owner when they make decisions.
Is aware of problems or issues that may affect the organization.
Creates a consistent process for prioritizing work.
Develops goals and establishes objective measures of success.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does what was promised.
Fosters an environment built upon trust.
Demonstrates honesty and truthfulness at all times.
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Takes responsibility for things that go wrong
Makes you feel enthusiastic about your work
Keep staff informed about what is happening in the company
Sets an example for others to follow
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Sets a good example.
Completes assigned work tasks.
Behavior is ethical and honest.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Recognizes individuals for a specific outstanding achievement.
Says "thank you" to show appreciation for work of others.
Reinforces and rewards employees for accomplishing necessary goals.
Finds opportunities to recognize others.
Recognizes team members who offer a significant contribution to a project.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits determination and passion in completion of goals.
Finds unique ways to go around barriers to success.
Devotes a certain amount of time and effort to developing new business opportunities.
Encourages dynamic growth opportunities.
Encourages risk taking for developing potential business opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to explain departmental policies and procedures to others.
Effective in communicating with others within the organization.
Adept at navigating within the culture of the department.
Is aware of other organizational cultures to compare/contrast with the current organizational culture.
Understands the current organizational culture.

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.