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
Forms working relationships with employees from other departments.
Consistently demonstrates ability and willingness to trust others.
Able to see issues from others' perspectives.
Works effectively with people from other departments.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Adapts coaching and mentoring approach to meet the style or needs of individuals
Works to identify root causes of performance problems
Takes immediate action on poor performance
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes responsibility for results.
Documents performance goals through an individual development plan.
Recognizes when a mistake is made and works to correct the issue.
Takes responsibility for errors in the production line.
Consults with the supervisor before engaging in new procedures that have some risk.
Persuasion and Influence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a good rapport with others.
Understanding what others need.
Has excellent influencing/negotiating skills.
Ensures stakeholders are involved in the decision making process.
Persuades others to consider alternative points of view.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports the Company's efforts to implement changes.
Assists others in understanding changes to the organization.
Inspires others to accept changes.
Develops plans for following through on the changes.
Able to get department employees to accept new 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.
Produces high quality work.
Demonstrates the analytical skills to do their job.
Can be counted on to add value wherever they are involved.
Keeps themselves and others focused on constant improvement.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes clear communications to avoid misunderstandings.
Able to clearly express thoughts and concerns.
Able to control their emotional responses and correctly gauge the emotions of others.
Conducts necessary preparations before engaging in negotiations.
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.