Problem Solving - 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

Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Ability to solve problems at root cause rather than at symptom level.
Identifies and assesses all potential responses to a problem.
Ability to develop innovative solutions to problems.
Works cooperatively with others to solve problems.
Able to balance the needs of different people in a solution to a problem.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses current capabilities before committing to new requests from customers.
Determines which tasks are critical and which tasks are optional.
Switches attention to more urgent tasks when necessary.
Builds in extra time in the schedule for unplanned events/occurrences.
Organizes tasks for the most efficient order of completion.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Tackles issues head on and finds solutions.
Keeps supervisor informed of recent events.
Holds team accountable to meeting goals.
Takes ownership of mistakes and learns from them.
Is someone you can trust.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates honesty and truthfulness at all times.
Fosters a high standard of ethics and integrity.
Does what was promised.
Accepts responsibility for mistakes.
Fosters an environment built upon trust.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Looks to others for input.
Shares past experiences with others as learning opportunities.
Is visible and approachable.
Accepts the views of others.
Asks others for their ideas and opinions.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Bases decisions on patterns found in fluid/changing information.
Tracks risks in a project.
Accurately perceives potential risks in the workplace.
Implements changes to reduce the chances of critical incidents in the future.
Tracks and monitors incidents that may increase the risk of adverse consequences.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Performs work safely.
Participates in safety training when available.
Ensures compliance with safety regulations.
Ensures that all supervisors are aware of regulatory and compliance measures.
Develops a culture of safety.
Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Identifies the most pressing needs of each client.
Ensures clients are comfortable with the services provided.
Obtains feedback to ensure client needs are being met.
Creates customized solutions for the client.
Makes client's needs a top priority.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to say "no" when it is essential to maintaining quality and high standards.
Is able to decline bad ideas to avoid making poor decisions.
Understands the expectations of other parties in the negotiation.
Establishes good working relationships with others.
Changes communication styles to meet the listener's needs.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Constructively receives criticism and suggestions from others.
Able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Consistently demonstrates ability and willingness to trust others.
Works across boundaries within the organization.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Impresses upon others the important aspects of [Company].
Understands the use of [Company] products and services.
Understands how decisions impact other business units beyond their immediate department of work group.
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.

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

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

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