Juggling Multiple Responsibilities - 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

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Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegates tasks aligned with team members growth goals to build capability while maintaining performance.
Is aware of the deadlines for specific tasks/assignments.
Ensures customers stay informed and confident when priorities shift, helping them navigate changes smoothly.
Maintains mental clarity and decision-making accuracy when switching between unrelated task domains.
Adjusts the schedule as needed to accommodate changes in the supply chain and resource availability.
Commitment	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Embodies responsibility and loyalty in pursuit of the firm's success.
Prioritizes organizational values and aligns personal effort with the mission, even when it requires sacrifice.
Enhances service quality by developing employee skills and fostering dedication to customer needs.
Models commitment through visible actions, inspiring employees to mirror dedication to goals.
Aligns personal talents with organizational needs through strengthened commitment.
Regulatory/Compliance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Reviews documentation, processes and practices.
Explains regulations and procedures to others as required.
Uses compliance reports to evaluate the effectiveness of compliance initiatives identifying areas of risk.
Develops a confidential reporting system to enable employees to anonymously report safety violations.
Coordinates the execution of compliance strategies across departments.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Swiftly adapts to changes, anticipates challenges and takes preemptive actions.
Permits flexible working and flex-time to accommodate employee needs to meet external obligations.
Promotes flexibility in approaches by encouraging employees to think outside the box and experiment with new methods and ideas.
Supports a culture that values flexibility, continuous improvement and innovation.
Adapts easily to incorporate various perspectives.
Leadership	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Rewards employees for innovation and calculated risk taking
Responds to performance feedback, identifying development opportunities (i.e., training) related to current job
Maintains high standards of honesty and integrity.
Encourages calculated risk-taking and treats mistakes as learning opportunities, not failures.
Sits down regularly with employees to review their job performance.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Creates clarity around roles, responsibilities, and success metrics.
Finds opportunities to recognize the accomplishments of high performers.
Demonstrates personal accountability by modeling the same expectations set for the team.
Anticipates potential obstacles and develops contingency plans to minimize disruption.
Maintains composure and professionalism when addressing performance issues or workplace tension.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes preventative measures to address quality issues before they escalate.
Systematically and thoroughly inspects products for consistency in meeting specifications.
Holds employees accountable for their quality of work.
Adjusts processes or procedures to improve quality results.
Committed to the improvement of the quality of services and products.
Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops and implements clear guidelines and protocols for handling tasks.
Able to solve problems with multiple criteria that need to be met.
Assumes new and difficult challenges and manages them as opportunities.
Focuses solutions on closing the gap between expected outcomes and the current situation.
Asks the right questions to size up or evaluate situations.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Experiments with new approaches that emerge from conflict discussions, turning conflict into creative momentum.
Defines escalation pathways so team members know when and how to involve higher authority.
Able to settle disputes equitably.
Addresses concerns about the availability of limited resources.
Combines ideas and viewpoints of different team members.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
A proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
Maintains communication channels between parties in the negotiation.
Is resolute when stating priorities and non-negotiables.
Is aware of what problems need to be solved.
Able to distinguish and navigate between different negotiation strategies and styles.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Gives spontaneous recognition in the proper context.
Measures improvements in performance from recognition programs.
Creates a "Collaborator Champion" award to promote and recognize teamwork and collaborative efforts by employees.
Uses recognition to encourage creativity and innovative thinking.
Implements a pilot program to test recognition initiatives before rolling them out to the general employee population.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Exhibits determination and passion in completion of goals.
Excellent at managing relationships with stakeholders.
Can work effectively in an environment of uncertainty.
Seeks and utilizes mentors to help guide professional development.
Encourages dynamic growth opportunities.

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

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

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