Responsibility - 360 Degree Feedback Survey Sample #6

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 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 and . 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
Is a person you can trust.
Works in a way that makes others want to work with her/him.
Sets a good example
...takes personal responsibility for results.
Acts as a resource without removing individual responsibility.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Builds and maintains the trust of others.
Is a person you can trust.
Demonstrates a sense of responsibility and commitment to public trust.
Delivers on promises made.
Takes ownership, delivers on commitments
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand and identify with the team's mission.
Excellent at managing time.
Functions well under stress, deadlines, and/or significant workloads.
Maintains self-control when personally criticized.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to do whatever it takes-not afraid to have to put in extra effort.
Coordinates all department activities into a cohesive team effort.
Able to focus on a task even when working alone.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Maintains persistence and dedication to achieving results.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates mastery of the technical competencies required in his/her work.
Willingly shares his/her technical expertise; sought out as resource by others
Knows how to produce high quality products/work.
Willingly shares information and expertise; sought out as resource by others
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
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.
Influences others through rational argument and persuasion.
Able to control their emotional responses and correctly gauge the emotions of others.
Maintains communication channels between parties in the negotiation.
Able to adapt to changing situations.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Looks for ways to expand current job responsibilities.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Looks for ways to expand and learn new job skills.
Looks for ways to improve work processes and procedures.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Communicates goals and objectives to employees.
Able to decline a poor strategy by proposing alternate strategies.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Looks for opportunities to enhance contributions to the bottom line.
Understands their role within the organization.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Works in an organized manner
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Delegates role to team members to accomplish goals.
Makes plans and follows through.

46. Overall, please rate the effectiveness of .
    

    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 's assessment.