Trustworthy - 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

Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You deliver on promises made.
You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
You demonstrate a sense of responsibility and commitment to public trust.
You communicate an understanding of the other person's interests, needs and concerns.
You build and maintain the trust of others.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You define roles, rights, and responsibilities of the team.
I maintain honesty and transparency in all communications.
You define roles, rights, and responsibilities of employees.
You do not make excuses for being late for work.
I set clear performance measures.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You accept responsibility for mistakes.
You establish relationships of trust, honesty, fairness, and integrity.
You develop trust and confidence from others.
You maintain strong relationships with others.
You protect the integrity and confidentiality of information
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You pursue learning that will enhance job performance.
You take the initiative to learn new skills.
You build on your strengths while addressing your weaknesses.
You are open to new ideas and concepts.
You improve on your skill sets.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain self-control when personally criticized.
You stay focused even when under pressure and stress.
You help guide employees with prioritizing tasks.
You are excellent at managing time.
You align the department's goals with the goals of the organization.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You achieve goals.
You make sure that I have a clear idea of our group's goals.
You conduct timely follow-up; keeps others informed on a need to know basis.
You establish and document goals and objectives.
You set challenging stretch goals
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage commitment in others to obtain results.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You coordinate all department activities into a cohesive team effort.
You take immediate action toward goals.
You are able to focus on a task even when working alone.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You adapt strategies to better meet the needs of the moment.
You collect information from various stakeholders, each with their own viewpoints, data, and interests.
I am aware of potential emotional triggers that could negatively impact the negotiations.
You conduct necessary preparations before engaging in negotiations.
I listen to all sides without bias and make fair decisions.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
You communicate goals and objectives to employees.
You make decisions that yield more competitive advantages.
I create a strategy to achieve departmental objectives.
I modified strategic decisions depending on changes in the business environment.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand the use of [Company] products and services.
You impress upon others the important aspects of [Company].
You understand how decisions impact other business units beyond your immediate department of work group.
You understand the "basics" as to how [Company] functions/operates.
You express loyalty and dedication to [Company] in interactions with others.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You anticipate resources needed to successfully implement a plan or project.
You establish a course of action for self and others to accomplish specific goals.
I develop strategic plans for the company/organization.
I determine what supplies/equipment will be needed for the job.
You understand what materials will be required to successfully implement the plan.

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

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

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