Integrity - 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

Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You foster an environment built upon trust.
You establish relationships of trust, honesty, fairness, and integrity.
You protect the integrity and confidentiality of information
You demonstrate sincerity in actions with others.
You follow tasks to completion.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are contributing fully to the extent of your skills
You seek opportunities for continuous learning.
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You encourage employees to take courses relevant to their job.
You allow employees to fully participate in employee training and professional development.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You seek to obtain consensus or compromise.
You are able to express own goals and needs.
You persuade others to consider alternative points of view.
You ensure stakeholders are involved in the decision making process.
You attempt to persuade others rather than simply control them.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You solve problems with insight and understanding.
You offer constructive improvements to existing systems.
You search for opportunities and innovative ways to improve the organization.
You create improved methods or solutions for meeting goals and objectives.
You create a safe environment for idea-sharing.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You follow-up and take action when goals are not met to ensure better results in the future.
You allocate resources as needed to accomplish organizational goals.
You complete work to a high technical standard
You set high standards in your performance
You are results oriented.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You demonstrate mastery of the technical competencies required in your work.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You know how to produce high quality products/work.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take a lot of pride in your work.
You are planful and organized.
You demonstrate the functional or technical skills necessary to do your job.
You keep yourself and others focused on constant improvement.
You produce high quality work.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You allow employees to make their own decisions.
You ensure employees understand what is being assigned to them.
You give employees autonomy to complete tasks on their own.
You provide support and resources needed to accomplish goals.
You let employees make their own decisions.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You coach employees in how to strengthen knowledge and skills to improve work performance.
You provide clear, motivating, and constructive feedback.
You conduct regular performance appraisals and feedback.
You help employees to maintain high personal standards.
You address employee behavior problems effectively.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I anticipate the impacts of strategic plans.
You create to-do lists to make sure nothing is missed.
I can develop an effective plan to guide the project.
You notify staff when the plan is not on schedule.
I develop plans to help manage expectations and project demands.

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.