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

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Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set high personal standards of performance.
You act as a resource without removing individual responsibility.
You take personal responsibility for results.
You hold yourself accountable to goals / objectives
You set a good example.
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 demonstrate a sense of responsibility and commitment to public trust.
You work in a way that makes others want to work with you.
You take care to maintain confidential information.
You build and maintain the trust of others.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You set appropriate goals for employees.
You help guide employees with prioritizing tasks.
You make sure that employees understand how their work relates to organizational goals.
You make sure that employees understand and identify with the team's mission.
You maintain self-control when personally criticized.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
You create a sense of urgency among the store team members to complete activities, which drive sales.
You are committed to the team.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You are able to focus on a task even when working alone.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You know how to produce high quality products/work.
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 demonstrate mastery of the technical competencies required in your work.
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.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I maintain a calm demeanor, even when discussions get heated.
You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
I am able to collaborate with others in solving problems to create solutions that satisfy both parties' interests.
You are able to control your emotional responses and correctly gauge the emotions of others.
You establish clear communications to avoid misunderstandings.
Continual Improvement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You look for ways to expand and learn new job skills.
You look for ways to improve work processes and procedures.
You promote training and development opportunities to enhance job performance.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You are open to the suggestions from others.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You assign individuals the responsibility of keeping track of progress toward achieving milestones.
I identify business strategies to strengthen competitive capabilities.
I pursue strategic alliances with valued partners.
You evaluate and review the implementation of the strategic plan to ensure achievement of the objectives.
I monitor company performance and make adjustments to the strategic plan as needed.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work in an organized manner
You are open to input from others into the plan for the project.
I anticipate challenges and have plans to overcome them.
You are able to closely follow the plan established for the department.
You ensure that everyone in the department is onboard with the current 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.