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 are proficient in the use of technical systems and processes.
You support technical training and development of employees.
You adopt the implementation of new technology into the workplace.
You apply complex rules and regulations to maintain optimal system performance.
You use technology in decision making and problem solving.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You tackle issues head on and finds solutions.
You are someone who is trustworthy.
You develop goals and establishes objective measures of success.
You create a consistent process for prioritizing work.
You act like an owner when they make decisions.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You foster a high standard of ethics and integrity.
You follow tasks to completion.
You protect the integrity and confidentiality of information
You demonstrate honesty and truthfulness at all times.
You accept responsibility for mistakes.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are ready to offer help
You set an example for others to follow
You keep staff informed about what is happening in the company
You take responsibility for things that go wrong
You make others feel enthusiastic about your work
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You complete reports on-time.
You are able to develop, justify and present a budget.
You have a high attention to detail.
You take responsibility for decisions.
You accurately implement contract provisions.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You work toward achievement of goals even when confronted with obstacles.
You provide clear expectations for employees.
You help others when free-time is available.
You stay focused on meeting the needs of customers.
You direct team in prioritizing daily work activities
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain positive customer relationships.
You consistently model positive customer service attitudes.
You develop strong customer relationships.
You ask questions and listen carefully to determine customer needs and to ensure that the customer's needs are met.
You do not hesitate to address customer concerns or complaints.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage others to obtain necessary skills and training.
You encourage employees to solve problems on your own.
You allow individuals to be responsible for your decisions.
You distribute the workload to subordinates.
You provide support and resources needed to accomplish goals.
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 give others development opportunities through project assignments and increased job responsibilities
You work to identify root causes of performance problems
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
You capitalize on partnerships and networks to enhance the Company's bottom line.
You support and encourage relationships that are created by diverse team members.
You develop a sense of trust in subordinates so they can freely interact and share information with others.
You maintain infrastructure to support partnerships and networks.
You create the conditions for partnerships to grow and develop.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You find unique ways to go around barriers to success.
You exhibit determination and passion in completion of goals.
You have a strategic awareness on how to promote the organization.
You are able to adapt the department to changing business demands and climate.
You encourage dynamic growth opportunities.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
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.
You are able to explain departmental policies and procedures to others.
You are effective in communicating with others within the organization.

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.