Mediation- 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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Mediation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Determines what documents are to be exchanged with each side.
Helps parties move from impasse to resolution without litigation or coercion.
Encourages creative problem-solving and consensus-building over positional bargaining.
Maintains neutrality while actively listening and validating each party's perspective.
Works with both parties to determine the most appropriate schedule and process.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does not lose sight of the big picture when making decisions
Employs sound judgment and logical reasoning.
Aligns choices with organizational goals by calculating expected value and costs.
Decides which long-term goals should be met.
Has enough self-control to avoid making impulsive decisions.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Accurately perceives potential risks in the workplace and initiates preventative measures.
Works effectively to mitigate risks.
Implements strategic risk management in an objective and tactical way.
Implement strategies to mitigate risks.
Attends risk management seminars and conferences.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is flexible in addressing issues related to quality.
Sets high benchmarks for employees to achieve.
Promotes quality improvement practices in the department.
Maintains detailed instructions to ensure consistency and quality in the production line.
Addresses barriers to successfully implementing quality standards.
Time Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Orders tasks based on impact and urgency.
Zeroes in on high-impact deliverables, bypassing low-value distractions.
Schedules deep-focus time for complex problem-solving and strategic planning.
Initially focuses on high priority items.
Manages inbox items promptly.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps employees come to accept changes.
Effective in implementing new organizational vision and values.
Able to get team members to change their attitudes.
Forms an effective change management team.
Identifies influential employees who can support the change and help spread enthusiasm across teams.
Delegation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Enables employees to take ownership of work delegated to them.
Establishes milestone reviews to assess progress and recalibrate expectations if needed.
Chooses the most qualified employee for the assignment.
Adjusts level of supervision based on task complexity, employee experience, and risk tolerance.
Encourages and empowers others to use initiative in achieving goals and objectives.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Promotes a culture of process-driven success, empowering teams to perform at their highest potential.
Fosters collaboration and accountability, ensuring success is a collective achievement.
Completed required training and certification.
Motivated to exceed performance goals.
Maintains unwavering commitment to goals.
Partnering/Networking	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Builds trust with colleagues and coworkers.
Develops internal alliances with others in the department.
Creates value within the Company by building networks.
Uses informal networks to share information.
Builds trust with colleagues at other companies to form partnerships to promote growth.

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

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

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