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

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Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Steps away from a situation to process appropriate response.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Does not allow own emotions to interfere with the performance of others.
Uses patience and self-control in working with customers and associates.
Professional Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Seeks opportunities for professional development.
Quickly acquire and apply new knowledge and skills when needed
Keep themselves up-to-date of technical/professional issues
Contributing fully to the extent of their skills
Allows employees to fully participate in employee training and professional development.
Punctuality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Starts the workday when scheduled.
Responds to requests for information in a timely manner.
Conducts appointments at scheduled start time.
Starts meetings on time.
Invoices clients on a timely basis.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Outlines specific behaviors and outcomes that constitute success in the role.
Re-aligns tasks with the larger organizational goals when needed.
Balances competing priorities by allocating time based on impact and deadlines.
Ensures the team stays on course and works effectively.
Anticipates potential challenges or obstacles that might derail department plans.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Decides which short- and long-term goals should be created.
Understands when gut instinct is helpful and when it needs to be supplemented with evidence.
Is able to make decisions quickly.
Skillfully integrates diverse and opposing information sources.
Uses reasonable assumptions and logic to decide between alternate courses of action
Creativity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Identifies creative opportunities to optimize operations.
Provides constructive criticism as critiques of newly created ideas/products.
Evaluates creative initiatives for effectiveness, feasibility, and impact.
Consistently brings fresh, unconventional ideas to the table.
Designs inventive solutions that improve efficiency or effectiveness.
Innovation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assigns responsibilities to individuals for creating innovative ideas/products.
Establishes priorities and allocates resources to support innovation.
Develops new products and services.
Embraces an open-minded approach allowing managers to discover and promote innovative solutions that drive business success.
Serves as an effective innovative champion.
Achievement	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has an intense drive to exceed expectations.
Always sets high standards for their work and the work of their colleagues.
Helps others to improve or meet standards of performance.
Met required benchmarks for the position.
Balances risk and reward with thoughtful strategies that propel success.
Excellence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is planful and organized.
Can be counted on to add value wherever they are involved.
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Demonstrates the functional or technical skills necessary to do their job.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is aware of OSHA safety guidelines.
Develops a strong safety culture.
Mitigates hazards and safety issues that arise.
Works to implement corrective safety measures.
Identifies predictable hazards in the workplace.
Developing Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Is open to receiving feedback.
Encourages employees through recognition of positive changes in behavior.
Tries to ensure employees are ready to move to the next level.
Recognizes and celebrates accomplishments of others.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Gives others development opportunities through project assignments and increased job responsibilities
Sets and clearly communicates expectations, performance goals, and measurements to others
Works to identify root causes of performance problems
Takes immediate action on poor performance
Adapts coaching and mentoring approach to meet the style or needs of individuals
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to clearly articulate the plan for the department/district.
Effectively uses logistics planning to reduce supply delays.
Divides complex tasks into smaller steps to measure progress toward a goal.
Sets up and monitors timeframes and plans
Creates a timeline for events and monitors progress.

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.