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
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
Respects the opinions of other employees.
Works effectively with people from other departments.
Works across boundaries within the organization.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes immediate action on poor performance
Sets and clearly communicates expectations, performance goals, and measurements to others
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
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Tackles issues head on and finds solutions.
Implements and facilitates controls and processes that maintain the integrity of the organization.
Accepts accountability for their actions and results.
Creates a consistent process for prioritizing work.
Keeps supervisor informed of recent events.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Communicates effectively with others.
Able to express own goals and needs.
Seeks to obtain consensus or compromise.
Persuades others to consider alternative points of view.
Ensures stakeholders are involved in the decision making process.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works cooperatively with others to implement changes.
Supports the Company's efforts to implement changes.
Addresses organizational and departmental resistance to changes.
Supports new initiatives for organizational changes to improve effectiveness.
Effective in implementing new organizational vision and values.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes a lot of pride in their work.
Is planful and organized.
Can be counted on to add value wherever they are involved.
Keeps themselves and others focused on constant improvement.
Produces high quality work.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Influences others through rational argument and persuasion.
Establishes clear communications to avoid misunderstandings.
Changes communication styles to meet the listener's needs.
Maintains good interpersonal relationships with representatives from the other party.
Able to control their emotional responses and correctly gauge the emotions of others.

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.