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

Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set a good example
You work in a way that makes others want to work with you.
You set a good example.
You are a person others can trust.
You are responsible for setting the vision of the department.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
You consistently keep commitments.
You are a person others can count on.
You take ownership, deliver on commitments
You deliver on promises made.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain focus when handling several problems or tasks simultaneously.
You function well under stress, deadlines, and/or significant workloads.
You help guide employees with prioritizing tasks.
You set appropriate goals for employees.
You maintain self-control when personally criticized.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You coordinate all department activities into a cohesive team effort.
You take immediate action toward goals.
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 encourage commitment in others to obtain results.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You know how to produce high quality products/work.
You are knowledgeable of procedures or systems necessary for the job.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You know the current business/market environment.
You are able to say "no" when it is essential to maintaining quality and high standards.
I control emotional responses to maintain a productive atmosphere.
You understand the expectations of other parties in the negotiation.
You identify verbal and nonverbal cues to help interpret actions and messages.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You look for ways to expand current job responsibilities.
You look for ways to improve work processes and procedures.
You are open to the suggestions from others.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Yoy scan both the internal and external environment to identify strategic opportunities to improve the organization.
You make decisions that yield more competitive advantages.
You create deadlines for various components of the strategy.
I develop a strategic vision for the future.
You are able to identify internal strengths and weaknesses and the opportunities and threats that impact the company.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I determine the allocation of funds based on plans for future development.
I make strategic and tactical decisions to guide the logistics process.
You allow input from others for the 5-year plan.
You establish a course of action for self and others to accomplish specific goals.
I ensure staff have the supplies and resources necessary to enact the plan.

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.