Teamwork- 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

Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Fosters respect and understanding among team members
Contributes to and supports team decision-making process
Builds relationships across boundaries and with key stakeholders by developing informal and formal networks.
Encourages collaboration with other departments.
Creates opportunities to learn with other team members
Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Does whatever it takes (within reason) to get the job done.
Works quickly when faced with difficult problems.
Makes effective decisions, even when under pressure.
Is not afraid to take corrective action when necessary.
Motivates & supports others to gain skills
Emotional Intelligence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to express themselves clearly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Accurately perceives the emotional reactions of others.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains self-control when personally criticized.
Aligns the department's goals with the goals of the organization.
Stays focused even when under pressure and stress.
Functions well under stress, deadlines, and/or significant workloads.
Helps guide employees with prioritizing tasks.
Project Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Anticipates potential problems and institutes controls and contingency plans to address them.
Develops action items, workplans, timelines, and criteria for projects.
Inspires others to accomplish goals and objectives.
Works with customers and clients to assess their needs and define project parameters.
Able to adjust project schedule as needed to accommodate unforeseen issues.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Addresses organizational and departmental resistance to changes.
Assists others in understanding changes to the organization.
Works cooperatively with others to implement changes.
Adopts changes to set and example for others to follow.
Supports the Company's efforts to implement changes.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Explains the "whys" behind organizational objectives
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Does not become distracted by non-issues or interruptions.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Helps others when free-time is available.
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Adopts the implementation of new technology into the workplace.
Understands and is committed to implementing new technologies.
Uses technology in decision making and problem solving.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Applies complex rules and regulations to maintain optimal system performance.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Expresses appreciation of other's work.
Anticipates the concerns of other employees.
Provides constructive feedback in a way that fosters acceptance and development.
Is a role model for others
Values the opinions of others.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes assigned work tasks.
...takes personal responsibility for results.
Responsible for setting the vision of the department.
Behavior is ethical and honest.
Acts as a resource without removing individual responsibility.

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

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

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