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

Technology Use/Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adopt the implementation of new technology into the workplace.
You support technical training and development of employees.
You use technology in decision making and problem solving.
You are proficient in the use of technical systems and processes.
You support employee training and development initiatives regarding implementation of technology.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are personally invested in the success of the organization.
You do not make excuses for being late for work.
You define roles, rights, and responsibilities of the team.
You inform supervisor of progress without having to be asked about it.
I willingly accept the consequences for my actions.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain strong relationships with others.
You develop trust and confidence from others.
You accept responsibility for mistakes.
You demonstrate sincerity in actions with others.
You follow tasks to completion.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take responsibility for things that go wrong
You make others feel enthusiastic about your work
You set an example for others to follow
You delegate tasks effectively
You are ready to offer help
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You complete reports on-time.
You take responsibility for decisions.
You are able to develop, justify and present a budget.
You are enthusiastic about taking on challenging projects.
You have strong technical/computer skills.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I prioritize tasks to best achieve the results.
You demonstrate the personal confidence to "stay the course," even when faced with difficulty
You direct team in prioritizing daily work activities
You complete work on time.
I help the team maintain focus on the goals.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You engage with customers on multiple levels.
You are above average in addressing the needs of the customers.
I create new and innovative products for customers.
You ensure all customer commitments and requirements are met or exceeded.
You attend to the customer's needs in addition to the specific needs of the project. Attended to the customer's needs in addition to the specific needs of the project.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You trust employees to complete tasks assigned.
I view others in the department as valued assets to be trained and employed.
I encourage employees to take the initiative when responding to an issue.
You give responsibility for making important decisions to employees.
I value the opinions of others.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt coaching and mentoring approach to meet the style or needs of individuals
You take immediate action on poor performance
You work to identify root causes of performance problems
You set and clearly communicate expectations, performance goals, and measurements to others
You give others development opportunities through project assignments and increased job responsibilities
Partnering/Networking	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop key business relationships with clients/customers.
I inspire employees to seek out new collaboration opportunities to broaden market reach.
I develop trust in others to form partnerships and networks.
You form strategic partnerships and business alliances to expand opportunities.
You identify the right alliance partners with complementary and compatible services and resources.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage dynamic growth opportunities.
You seek and utilize mentors to help guide your professional development.
You understand the processes and various stages of business development.
You devote a certain amount of time and effort to developing new business opportunities.
You encourage risk taking for developing potential business opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are aware of other organizational cultures to compare/contrast with the current organizational culture.
You are adept at navigating within the culture of the department.
You are able to use corporate politics to advance department objectives.
You understand departmental policies and procedures.
You are able to deal with sensitive issues with tact and professionalism.

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.