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
Works with other team members on the project.
Helps other team members to research solutions to a problem.
Lets team members know when they have done well.
Encourages other team members to adopt new procedures.
Listens and is attentive to other team members.
Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Displays high energy and enthusiasm on consistent basis.
Gets the job done.
Changes course to meet the needs of a new situation.
Takes the initiative and does not wait for the situation to change.
Addresses safety issues immediately.
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 able to express themselves clearly.
Accurately perceives the emotional reactions of others.
Is able to control their own emotions.
Is able to manage their own emotions.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains self-control when personally criticized.
Excellent at managing time.
Helps guide employees with prioritizing tasks.
Sets appropriate goals for employees.
Maintains focus when handling several problems or tasks simultaneously.
Project Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Presents clear and accurate status information to required constituents.
Understands what software tools are available to be used to manage the project.
Has detailed knowledge about the project and can adapt the project plan as needed.
Monitors finances to ensure optimal use of project funds.
Follows progress on the project from initial phase to completion.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Inspires others to want to change.
Effective in dealing with ambiguous and challenging situations.
Inspires others to accept changes.
Adopts changes to set and example for others to follow.
Able to get department employees to accept new changes.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets benchmarks and milestones to measure progress toward the objectives.
Quickly analyzes the situation to determine the most pressing needs.
Is considered a high achiever.
Promptly and efficiently completes assigned tasks.
Flexible in adjusting priorities to meet the demands of changing situations.
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Uses technology in decision making and problem solving.
Understands and is committed to implementing new technologies.
Proficient in the use of technical systems and processes.
Maximizes the use of new technology to deliver products and services.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is trusted by peers and co-workers; others are willing to confide in him/her
Demonstrates willingness to work with others.
Assists employees that need help.
Demonstrates positive behaviors for others to follow.
Is thoughtful and honest about the feedback they give others.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes assigned work tasks.
Responsible for setting the vision of the department.
Is a person you can trust.
Holds herself / himself accountable to goals / objectives
Sets a good example.

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.