Interpersonal Skills - 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

Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I take time to recognize the efforts of others.
I am honest about making mistakes and willing to fix them.
I value the input from coworkers.
You create an atmosphere that supports the open expression of ideas
I am someone you can trust.
Passion To Learn	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
You enjoy learning new skills and techniques.
You enhance your value to the company through additional training and development.
You inspire others to learn new things.
You create an environment that supports personal development and exploration.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You treat all people fairly and with respect.
You visibly support and encourages diversity in style and background.
You work to eliminate unnecessary work or barriers that get in others' way.
You contribute to a positive work environment.
You are gracious and professional in your interactions with others.
Time Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You accurately capture time across various tasks.
You record time spent on work and non-work related items.
I use a journal, log, or schedule to keep track of how much time is spent doing each task.
You delegate routine tasks to team members, allowing you to concentrate on more strategic or complex responsibilities.
You avoid distractions in the workplace.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You complete work promptly and efficiently.
You successfully complete the orientation training program.
Your work improves the quality of work on the production line.
You demonstrate a sense of urgency to quickly and accurately solve problems and issues.
You take calculated risks.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are knowledgeable of procedures or systems necessary for the job.
You demonstrate mastery of the technical competencies required in your work.
You seek information from others as needed.
You willingly share information and expertise; sought out as resource by others
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.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You reward innovative experiments to try new ideas.
You are knowledgeable of standard risk management principles.
You base decisions on patterns found in fluid/changing information.
You work within constraints of the organization.
You develop policies to address risk situations in the workplace.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate a sense of responsibility and commitment to public trust.
You build and maintain the trust of others.
You take ownership, deliver on commitments
You work in a way that makes others want to work with you.
You take care to maintain confidential information.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You change communication styles to meet the listener's needs.
You are able to control your emotional responses and correctly gauge the emotions of others.
You are flexible in responses.
You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
You are able to decline bad ideas to avoid making poor decisions.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to identify internal strengths and weaknesses and the opportunities and threats that impact the company.
You make sure employees understand the strategy and goals.
I strategically position resources to meet the needs of branch locations.
I maintain strategic focus by regularly reviewing the strategic plan and taking corrective actions as needed to stay on track.
You create a mission statement describing the purpose for the organization.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You allow input from others for the 5-year plan.
I ensure staff have the supplies and resources necessary to enact the plan.
You are able to clearly articulate the plan for the department/district.
I divide complex tasks into smaller steps to measure progress toward a goal.
You ensure that everyone in the department is onboard with the current plan.

56. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
57. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
58. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
59. Additional comments, if any for [Participant Name Here]'s assessment.