Technology Use/Management - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 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. A report will be shared with you at the conclusion of this project.

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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Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are proficient in the use of technical systems and processes.
You maximize the use of new technology to deliver products and services.
You understand and are committed to implementing new technologies.
You apply complex rules and regulations to maintain optimal system performance.
You identify gaps between actual and needed technical competencies and provide recommendations for required training.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You consult with the supervisor before engaging in new procedures that have some risk.
You accept accountability for your actions and results.
You take ownership of problems to find the best solutions.
You establish who is responsible for various aspects of the project.
You make sure the supervisor is always informed of any important events.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You accept responsibility for mistakes.
You demonstrate honesty and truthfulness at all times.
You develop trust and confidence from others.
You follow tasks to completion.
You establish relationships of trust, honesty, fairness, and integrity.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You keep staff informed about what is happening in the company
You take responsibility for things that go wrong
You are ready to offer help
You delegate tasks effectively
You set an example for others to follow
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to develop, justify and present a budget.
You have strong technical/computer skills.
You have strong organizational skills to keep the workspace and department in order
You accurately implement contract provisions.
You complete reports on-time.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I determine the proper order for completion of the tasks.
I set challenging goals to be achieved.
You have a strong result orientation.
I determine the objectives for the project.
You provide clear expectations for employees.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I am focused on improving customer services.
You deliver on commitments made to customers.
I prioritize customer issues based on urgency.
I exceed expectations of the customers.
I act with integrity in all customer interactions.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You give employees the opportunity to make their own decisions at work.
I give employees important tasks to expand their career options.
I give new tasks to employees.
You ensure employees understand what is being assigned to them.
I give employees the resources they need to complete the job.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work to identify root causes of performance problems
You give others development opportunities through project assignments and increased job responsibilities
You adapt coaching and mentoring approach to meet the style or needs of individuals
You take immediate action on poor performance
You set and clearly communicate expectations, performance goals, and measurements to others
Partnering/Networking	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I engage in collaborative training sessions or workshops to build skills across organizations.
You build alliances between departments and teams.
You form strategic partnerships and business alliances to expand opportunities.
I seek opportunities to collaborate across organizational boundaries.
You establish appropriate monitoring of activities in the network.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You balance risks and rewards when making decisions.
You seek and utilize mentors to help guide your professional development.
You are able to adapt the department to changing business demands and climate.
You find unique ways to go around barriers to success.
You devote a certain amount of time and effort to developing new business opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate problems that may affect the department.
You are effective in communicating with others within the organization.
You are adept at navigating within the culture of the department.
You get things done through the department.
You understand departmental policies and procedures.

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

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

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