Self-Management - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

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 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

Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does not allow own emotions to interfere with the performance of others.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Uses patience and self-control in working with customers and associates.
Analyzes interpersonal problems instead of reacting to them.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages employees to take courses relevant to their job.
Seeks opportunities for continuous learning.
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for professional development.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Arrives to meetings on time.
Conducts appointments at scheduled start time.
Responds to requests for information in a timely manner.
Starts meetings on time.
Avoids making personal phone calls during working hours.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains focus when handling several problems or tasks simultaneously.
Functions well under stress, deadlines, and/or significant workloads.
Sets appropriate goals for employees.
Stays focused even when under pressure and stress.
Maintains self-control when personally criticized.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Defines parameters that will impact the decision making process.
Examines for patterns in data to help predict future possibilities.
Willing to consider information from other sources.
Weighs the pros and cons of decisions.
Takes into account the impact decisions will have on others.
Creativity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Inspires creativity in their team.
Conceives, implements and evaluates ideas.
Is creative and inspirational.
Develops solutions to challenging problems.
Creates a lot of new ideas.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters a creative and innovative work environment.
Takes risks to advance important ideas.
Creates improved methods or solutions for meeting goals and objectives.
Offers constructive improvements to existing systems.
Challenges current procedures to develop other alternatives.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Takes reasonable risks to achieve desired results.
Takes calculated risks to achieve higher levels of performance.
Completed required training and certification.
Increased customer satisfaction scores for the quarter.
Demonstrates a well-organized and timely approach to achieve desired results
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Can be counted on to add value wherever they are involved.
Keeps themselves and others focused on constant improvement.
Demonstrates the functional or technical skills necessary to do their job.
Is planful and organized.
Takes a lot of pride in their work.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works to implement corrective safety measures.
Encourages others to work safely.
Participates in safety training when offered.
Ensures that all supervisors are aware of regulatory and compliance measures.
Is not afraid to question a potential safety issue observed in the workplace.
Developing Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is open to receiving feedback.
Supports the successes of other employees.
Provides constructive feedback to others.
Tries to ensure employees are ready to move to the next level.
Creates opportunities for professional development.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets and clearly communicates expectations, performance goals, and measurements to others
Provides ongoing feedback to co-workers on their development progress
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Takes immediate action on poor performance
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses the risks of various strategic plans.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Makes plans and follows through.
Creates effective project plans.
Accurately estimates the amount of materials/supplies needed for the project.

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

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

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