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

Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helpful
Is able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Respects the opinions of other employees.
Consistently demonstrates ability and willingness to trust others.
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
Provides ongoing feedback to co-workers on their development progress
Takes immediate action on poor performance
Sets and clearly communicates expectations, performance goals, and measurements to others
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure the supervisor is always informed of any important events.
Sets clear performance measures.
Accepts personal responsibility for not meeting expectations.
Projects an image of transparency and trustworthiness in the administration of fair and equitable policies.
Works hard to ensure the success of the department.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to express own goals and needs.
Persuades others to consider alternative points of view.
Understanding what others need.
Has excellent influencing/negotiating skills.
Communicates effectively with others.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports the Company's efforts to implement changes.
Inspires others to want to change.
Addresses organizational and departmental resistance to changes.
Develops a strategy for implementing changes.
Is a leading force driving changes.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the functional or technical skills necessary to do their job.
Is planful and organized.
Keeps themselves and others focused on constant improvement.
Produces high quality work.
Takes a lot of pride in their work.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Aims for solutions that benefit both parties.
Leverages relationships with others to achieve goals.
Demonstrates emotional stability to facilitate productive problem-solving and relationship building.
Persuades the other party of the benefits of our proposals.
Actively listens to conversations to be able to recall important details later.

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.