Recognition- 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

Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Compliments other people when they do good work
Recognizes the abilities and skills of self and others
Readily shares credit and gives others opportunity for visibility.
Lets employees know when they have done well
Offers recognition in a timely manner.
Developing Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Recognizes and celebrates accomplishments of others.
Encourages employees through recognition of positive changes in behavior.
Is open to receiving feedback.
Tries to ensure employees are ready to move to the next level.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters an environment built upon trust.
Demonstrates sincerity in actions with others.
Follows tasks to completion.
Demonstrates honesty and truthfulness at all times.
Accepts responsibility for mistakes.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Produces high quality work.
Is planful and organized.
Can be counted on to add value wherever they are involved.
Takes a lot of pride in their work.
Demonstrates the analytical skills to do their job.
Performance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
...Overall Performance
Listens and responds to issues and problems
Effectively organizes resources and plans
Shown significant improvement in job performance.
Effective in performing his/her job.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops safety guidelines for the department.
Creates accurate and effective measures of safety.
Encourages others to work safely.
Develops a strong safety culture.
Is not afraid to question a potential safety issue observed in the workplace.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Forms working relationships with employees from other departments.
Works effectively with people from other departments.
Helpful
Includes others in the decision making processes.
...treats others with respect and dignity.

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.