Responsibility - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 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. A report will be shared with you at the conclusion of this project.

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

Edit this Survey

Would you like to edit this survey? Click here to begin.

Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set a good example
You act as a resource without removing individual responsibility.
You hold yourself accountable to goals / objectives
You are a person others can trust.
You work in a way that makes others want to work with you.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You consistently keep commitments.
You demonstrate a sense of responsibility and commitment to public trust.
You take care to maintain confidential information.
You are trustworthy; is someone that can be trusted.
You demonstrate congruence between statements and actions.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I use performance data to reinforce expectations and guide improvement.
You identify gaps in infrastructure or support and proactively address them.
I establish processes and structure to steer the organization in a clear, strategic direction.
I develop frameworks and systems to guide the organization toward achieve its goals.
I identify early signs of misalignment and intervene to restore focus and direction.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are committed to the team.
You are able to focus on a task even when working alone.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You create a sense of urgency among the store team members to complete activities, which drive sales.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You willingly share your technical expertise; sought out as resource by others
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You willingly share information and expertise; sought out as resource by others
You seek information from others as needed.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I can tailor my approache to more effectively address current demands.
I identify tradeable interests that could facilitate reaching a consensus.
You are prepared to walk away if core interests are not met.
I keep a firm grasp on the issues and priorities.
You are committed to working with both sides and openly sharing information.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You look for ways to improve work processes and procedures.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
You look for ways to expand current job responsibilities.
You look for ways to expand and learn new job skills.
I foster a culture of open communication and continuous improvement.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I identify ways in which the company is better able to meet the customers' needs than rivals.
You understand how to grow the business and increase customers.
You reinforce the strategic messaging in various teams, meetings, seminars and workshops.
You avoid complacency and strives to be ahead of changes in the business environment.
I ensure adherence to the strategy to sustain achievement of targeted levels of organizational performance.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I identify resource requirements that may impact the development of the 5-year plan.
You establish a course of action for self and others to accomplish specific goals.
You accomplish major tasks by breaking them into manageable pieces.
I divide complex tasks into smaller steps to measure progress toward a goal.
I analyze market trends to plan the best course of action.

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

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

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