Planning- 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

Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to identify the needs of the department before a major change.
Makes plans and follows through.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Anticipates obstacles and ways to overcome them.
Works in an organized manner
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates sincerity in actions with others.
Accepts responsibility for mistakes.
Fosters an environment built upon trust.
Protects the integrity and confidentiality of information
Develops trust and confidence from others.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets relevant learning objectives and goals.
Shares best practices with others and learns from others.
Pursues learning that will enhance job performance.
Participates in regular training offered.
Takes charge of their training and skills enhancement.
Attitude	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Contributes to a positive and fun work environment.
Contributes to a positive work environment.
Visibly supports and encourages diversity in style and background.
Builds open and trusting relationships.
Works to eliminate unnecessary work or barriers that get in others' way.
Cultural Awareness	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages a work environment where individual differences are valued.
Fosters a diverse workforce free from discrimination and harassment.
Values the opinions of diverse groups and individual.
Seeks out different viewpoints and benefits from different perspectives.
Treats others with dignity and respect.
Project Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops action items, workplans, timelines, and criteria for projects.
Organizes, plans, and directs resources to accomplish the goals and objectives.
Responds quickly and appropriately to unforeseen problems.
Maintains costs and expenses within budget limits.
Anticipates potential problems and institutes controls and contingency plans to address them.
Analytical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Implements data validation techniques and methods.
Prioritizes various actions to be taken when solving a problem.
Balances risks and costs with the rewards and probabilities of success when decisions.
Analyzes data and information from several sources and arrives at logical conclusions.
Identifies the root cause of a problem.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Corrects issues in a timely manner.
Holds employees accountable for their quality of work.
Encourages others to achieve high quality standards.
Encourages employees to produce the best quality products.
Reflects on what is working and what could be improved.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Challenges current procedures to develop other alternatives.
Builds upon the ideas and solutions of others.
Implements best practices within the department.
Suggests new ideas at meetings.
Offers constructive improvements to existing systems.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works to identify root causes of performance problems
Sets and clearly communicates expectations, performance goals, and measurements to others
Provides ongoing feedback to co-workers on their development progress
Gives others development opportunities through project assignments and increased job responsibilities
Adapts coaching and mentoring approach to meet the style or needs of individuals

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

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

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