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
Is sincerely interested in the suggestions of co-workers
Lets employees know when they have done well
Makes people around them feel appreciated and valued.
Recognizes team members who offer a significant contribution to a project.
Offers recognition in a timely manner.
Developing Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Tries to ensure employees are ready to move to the next level.
Assesses employees' developmental needs.
Recognizes and celebrates accomplishments of others.
Creates a work environment that fosters positive feedback to employees.
Is open to receiving feedback.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops trust and confidence from others.
Follows tasks to completion.
Fosters an environment built upon trust.
Does what was promised.
Fosters a high standard of ethics and integrity.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the functional or technical skills necessary to do their job.
Is planful and organized.
Demonstrates the analytical skills to do their job.
Takes a lot of pride in their work.
Can be counted on to add value wherever they are involved.
Performance	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works effectively in the department.
Shown significant improvement in job performance.
...Produce Quality
Effectively organizes resources and plans
...Overall Performance
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works to implement corrective safety measures.
Develops safety guidelines for the department.
Participates in safety training when available.
Performs work safely.
Commits adequate resources toward safety measures.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Includes others in the decision making processes.
Helpful
Constructively receives criticism and suggestions from others.
Works across boundaries within the organization.
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.