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

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Teamwork	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willingly share their technical expertise
Works with other team members to identify bottle necks in the production process.
Helps the team exercise good judgment by making sound and informed decisions.
Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
Carries his/her share of the workload
Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Persists in work despite obstacles encountered.
Anticipates needs and takes pre-emptive action to address the issue.
Does not procrastinate when there is a job to be done.
Initiates projects or tasks that have a positive impact on the team.
Takes action when opportunities arise.
Emotional Intelligence	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to express themselves clearly.
Is attentive to emotional cues and interprets others' feelings correctly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Able to understand others' points of view.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Monitors the workload balance and their impact on employees.
Encourages employees to focus on getting results now.
Identifies areas for improvement and makes any necessary course corrections.
Allocates time, personnel, and tools based on task complexity and team capacity.
Ensures that each team member is assigned some part of the project.
Project Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Uses appropriate technology to efficiently communicate with team members.
Hold team members accountable for completing specific tasks on the project.
Prepares and utilizes QC Checklists to ensure high quality.
Develops action items, workplans, timelines, and criteria for projects.
Establishes the scope for the project.
Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Recognizes progress and achievements to reinforce motivation and commitment to the change.
Leads a cross-functional team with employees from different departments to implement changes.
Acts with agility in various situations.
Conducts a market competitive analysis to determine where the organization may need to change to better meet the needs of the marketplace.
Builds organizational awareness of the need for changes.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Follows up consistently on commitments and deadlines to ensure progress is sustained.
Directs team in prioritizing daily work activities
Sets challenging goals to be achieved.
Pursues performance benchmarks despite obstacles and setbacks.
Recognizes the problem that needs to be solved.
Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Adopts the implementation of new technology into the workplace.
Supports employee training and development initiatives regarding implementation of technology.
Uses technology in decision making and problem solving.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Proficient in the use of technical systems and processes.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Attends to both the content and the context of what was being said.
Anticipates the concerns of other employees.
Builds a strong rapport with co-workers.
Is honest about making mistakes and willing to fix them.
Assists employees that need help.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Sets a good example.
Completes assigned work tasks.
Responsible for setting the vision of the department.
...takes personal responsibility for results.
Is a person you can trust.

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.