Others- 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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Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helpful
Constructively receives criticism and suggestions from others.
Respects the opinions of other employees.
Supports the efforts of other employees in implementing solutions to problems.
Forms working relationships with employees from other departments.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works to identify root causes of performance problems
Gives others development opportunities through project assignments and increased job responsibilities
Sets and clearly communicates expectations, performance goals, and measurements to others
Provides ongoing feedback to co-workers on their development progress
Adapts coaching and mentoring approach to meet the style or needs of individuals
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is someone you can trust.
Willingly accepts the obligation to complete the task.
Able to complete required tasks on time and delivered expected results.
Consistently strives to complete work on time or ahead of schedule.
Accepts personal responsibility for their actions.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a good rapport with others.
Has excellent influencing/negotiating skills.
Communicates effectively with others.
Understanding what others need.
Seeks to obtain consensus or compromise.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Adopts changes to set and example for others to follow.
Facilitates change with minimal resistance.
Assists others in understanding changes to the organization.
Effective in implementing new organizational vision and values.
Effective in dealing with ambiguous and challenging situations.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is planful and organized.
Demonstrates the analytical skills to do their job.
Produces high quality work.
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Manages emotions to reduce the impact of negativity.
Is resolute when stating priorities and non-negotiables.
Is an effective negotiator, fostering positive relationships and achieving good outcomes.
Is aware of and manages own emotions and understands the emotions of others which helps in navigating tense situations and in finding common ground.
Able to adapt to changing situations.

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

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

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