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
Your behavior is ethical and honest.
You set a good example.
You act as a resource without removing individual responsibility.
You complete assigned work tasks.
You hold yourself accountable to goals / objectives
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You build and maintain the trust of others.
You take care to maintain confidential information.
You are trustworthy; is someone that can be trusted.
You take ownership, deliver on commitments
You communicate an understanding of the other person's interests, needs and concerns.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You stay focused even when under pressure and stress.
You are excellent at managing time.
You maintain self-control when personally criticized.
You function well under stress, deadlines, and/or significant workloads.
You help guide employees with prioritizing tasks.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain persistence and dedication to achieving results.
You are able to focus on a task even when working alone.
You coordinate all department activities into a cohesive team effort.
You encourage commitment in others to obtain results.
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 willingly share information and 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 seek information from others as needed.
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
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to adapt to changing situations.
You are able to decline bad ideas to avoid making poor decisions.
You are flexible in responses.
You are able to control your emotional responses and correctly gauge the emotions of others.
You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are open to the suggestions from others.
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 analyze processes to determine areas for improvement.
You look for ways to expand current job responsibilities.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You focus attention on treating the causes of problems rather than simply addressing the symptoms.
You are able to decline a poor strategy by proposing alternate strategies.
You look for opportunities to enhance contributions to the bottom line.
You sustain or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
You understand your role within the organization.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate potential challenges, develops plan to overcome them and then carries out the plan.
You anticipate obstacles and ways to overcome them.
You work in an organized manner
You delegate role to team members to accomplish goals.
You make plans and follows through.

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.