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 adopt the implementation of new technology into the workplace.
You use technology in decision making and problem solving.
You are proficient in the use of technical systems and processes.
You maximize the use of new technology to deliver products and services.
You support technical training and development of employees.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I regularly lead the way when helping the team troubleshoot various issues.
You are someone who is trustworthy.
You willingly accept the obligation to complete the task.
I take full responsibility for unmet expectations and make corrective actions immediately.
I accept personal responsibility for producing high quality and timely work.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop trust and confidence from others.
You do what was promised.
You follow tasks to completion.
You accept responsibility for mistakes.
You demonstrate honesty and truthfulness at all times.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take responsibility for things that go wrong
You keep staff informed about what is happening in the company
You delegate tasks effectively
You set an example for others to follow
You make others feel enthusiastic about your work
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You have strong technical/computer skills.
You accurately implement contract provisions.
You are able to develop, justify and present a budget.
You complete reports on-time.
You take responsibility for decisions.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make changes to the plans if it will result in increased output.
I have a positive attitude that encourages others to continue supporting the production goals.
You do not become distracted by non-issues or interruptions.
You are a high achiever.
You are focused on achieving important goals.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You put customer's needs first.
You deliver high quality products to the customer.
I provide training to others on how to improve customer service.
I am persistent in solving customer issues.
You are aware of the customer's needs.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You allow employees to make their own decisions.
I allow the team to take responsibility for the project.
I give employees opportunities to demonstrate their skills.
You encourage employees to solve problems on your own.
I support the decisions of others even if those decisions may sometimes lead to mistakes.
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 adapt coaching and mentoring approach to meet the style or needs of individuals
You provide ongoing feedback to co-workers on your development progress
You take immediate action on poor performance
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
I am comfortable working in partnership with colleagues from other departments.
You build trust with colleagues at other companies to form partnerships to promote growth.
You facilitate communication with others in the company.
I inspire employees to seek out new collaboration opportunities to broaden market reach.
I find common ground with a wide range of stakeholders.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage risk taking for developing potential business opportunities.
You have a strategic awareness on how to promote the organization.
You devote a certain amount of time and effort to developing new business opportunities.
You can work effectively in an environment of uncertainty.
You are able to adapt the department to changing business demands and climate.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are effective in communicating with others within the organization.
You understand the current organizational culture.
You are adept at navigating within the culture of the department.
You anticipate problems that may affect the department.
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.