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 maintain strong relationships with others.
You foster a high standard of ethics and integrity.
You establish relationships of trust, honesty, fairness, and integrity.
You develop trust and confidence from others.
You demonstrate sincerity in actions with others.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You allow employees to fully participate in employee training and professional development.
You seek opportunities for professional development.
You seek opportunities for continuous learning.
You are contributing fully to the extent of your skills
You keep yourself up-to-date of technical/professional issues
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to express own goals and needs.
You develop a good rapport with others.
You communicate effectively with others.
You attempt to persuade others rather than simply control them.
You ensure stakeholders are involved in the decision making process.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You challenge current procedures to develop other alternatives.
You suggest new ideas at meetings.
You implement best practices within the department.
You encourage open communication to ensure that all proposals are considered.
You build upon the ideas and solutions of others.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to increase customer satisfaction scores for the quarter.
You set high standards in your performance
You systematically work to improve the organization
You are flexible in adjusting priorities to meet the demands of changing situations.
You complete work to given time frame and to budget
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You willingly share information and expertise; sought out as resource by others
You are knowledgeable of procedures or systems necessary for the job.
You know how to produce high quality products/work.
You willingly share your technical expertise; sought out as resource by others
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You produce high quality work.
You can be counted on to add value wherever you are involved.
You demonstrate the functional or technical skills necessary to do your job.
You demonstrate the analytical skills to do your job.
You keep yourself and others focused on constant improvement.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage employees to solve problems on your own.
I acknowledge and appreciate employees for their proactive decision-making.
I allow employees to take ownership of their work.
I recognize the expertise that employees have in certain areas and allow them the freedom to operate as they see fit.
You distribute the workload to subordinates.
Coaching	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You help employees to understand responsibilities, authority, and expectations.
You address employee behavior problems effectively.
You provide clear, motivating, and constructive feedback.
You develop the skills and capabilities of others.
You coach employees in how to strengthen knowledge and skills to improve work performance.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am able to efficiently manage deadlines.
I can adjust and rearrange the schedule to maximize efficiency.
I can develop a detailed plan outlining tasks, resources, timelines, and deliverables.
I develop strategic plans for the company/organization.
I can create effective logistics plans to achieve high operational efficiency.

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.