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
I track the percentage of code generated with AI assistance by the team.
I recognize and address cultural barriers to technology use, such as resistance, fear, or outdated norms.
You identify the technical skills required for current and emerging technologies and ensure the team has the right mix of talent to support them.
I encourage cross-functional knowledge sharing about effective technology practices.
I ensure third-party tools, plugins, and AI services used by the team meet security, privacy, and compliance criteria.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take full responsibility for project outcomes.
You can be counted on to do your role well.
You accept accountability for your work.
I consistently strive to meet high standards of excellence.
You accept personal responsibility for not meeting expectations.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop trust and confidence from others.
You accept responsibility for mistakes.
I openly admit to errors and take responsibility, showcasing dedication to integrity, transparency and ethical behavior.
You can be trusted to do the right thing.
You maintain a consistent level of integrity in all situations to earn the trust and respect of your colleagues and subordinates.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I effectively coordinate the personnel required for completion of a job.
I set clear and ambitious goals to be met.
You ensure the department consistently achieves production targets on time.
I acknowledge and celebrate when employees take initiative or solve problems on their own.
You effectively allocate resources to sustain and grow the business/department.
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I prepare payroll and tax forms/reports.
You proactively identify and address the needs of colleagues, clients, or stakeholders to providing effective support.
You answer phone calls and direct calls to appropriate parties or take messages.
You prepare and distribute documents/reports.
I provide context when delivering information so employees understand the purpose and relevance of the message.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You help others when free-time is available.
You coordinate cross-functional efforts to ensure dependencies are addressed proactively.
You give extra effort to solve problems and get work done on time.
You are determined to complete tasks regardless of obstacles that may occur.
You set the objectives for the team.
Customer Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop good rapport and trust with the customer.
You interact with customers to define roles, expectations, and responsibilities.
I take the initiative in solving difficult customer issues.
I ensure every customer receives the same high standard of service, regardless of the situation.
I keep the customer informed of all progress.
Empowering Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage employees to define their own goals and success metrics for assign work.
You set clear goals for others to accomplish.
I allow employees to take on more responsibilities.
You create opportunities for employees to exercise their independence.
You set clear goals for assignments.
Co-worker Development	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You provide ongoing feedback to co-workers on your development progress
You take immediate action on poor performance
You set and clearly communicate expectations, performance goals, and measurements to others
You give others development opportunities through project assignments and increased job responsibilities
You work to identify root causes of performance problems
Partnering/Networking	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I form strategic alliances with firms that specialize in areas that are complementary or help the company.
I collaborate with other departments to streamline and improve workflow efficiency.
You maintain infrastructure to support partnerships and networks.
You proactively surface emerging concerns or misalignments to partners early, preventing small issues from escalating into larger conflicts.
You ensure all participants in the network are treated fairly and equitably.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You transform emerging ideas into new offerings that expand the department's value proposition.
You create value for the organization.
You maintain an optimistic environment in the department.
You have a strategic awareness on how to promote the organization.
You exhibit a high sense of self-belief.
Organizational Fluency	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to deal with sensitive issues with tact and professionalism.
You get things done through the department.
You understand the current organizational culture.
You are able to explain departmental policies and procedures to others.
You anticipate problems that may affect the department.

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.