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 take ownership, deliver on commitments
You take care to maintain confidential information.
You are a person others can count on.
You are trustworthy; is someone that can be trusted.
You consistently keep commitments.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You take responsibility for your actions and admit mistakes openly.
You consult with the supervisor before engaging in new procedures that have some risk.
You can be counted on to do what you say you are going to do.
I ensure that employees are compensated fairly and in accordance with established policies.
I regularly lead the way when helping the team troubleshoot various issues.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You foster a high standard of ethics and integrity.
You demonstrate honesty and truthfulness at all times.
You follow tasks to completion.
You foster an environment built upon trust.
You do what was promised.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are open to new ideas and concepts.
You grasp new ideas, concepts, technical, or business knowledge.
You take the initiative to learn new skills.
You improve on your skill sets.
You participate in regular training offered.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain self-control when personally criticized.
You make sure that employees understand how their work relates to organizational goals.
You make sure that employees understand and identify with the team's mission.
You align the department's goals with the goals of the organization.
You stay focused even when under pressure and stress.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand and contribute to development of strategic goals.
You achieve established goals.
You achieve goals.
You set challenging stretch goals
You make sure that I have a clear idea of our group's goals.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are committed to the team.
You create a sense of urgency among the store team members to complete activities, which drive sales.
You maintain persistence and dedication to achieving results.
You coordinate all department activities into a cohesive team effort.
You take immediate action toward goals.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
You maintain good interpersonal relationships with representatives from the other party.
You leverage relationships with others to achieve goals.
You change communication styles to meet the listener's needs.
You conduct necessary preparations before engaging in negotiations.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop strategies to seek new opportunities.
You identify bottlenecks in the production process and develops strategies to correct these issues.
I develop a strategic plan to focus on strategic issues.
I understand how to achieve strategic financial objectives.
You identify the role of each department in meeting the strategic goals.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand how decisions impact other business units beyond your immediate department of work group.
You follow existing procedures and processes.
You attend [Company] gatherings and social events.
You understand the use of [Company] products and services.
You impress upon others the important aspects of [Company].
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I determine staffing needs for the project/department.
You set the appropriate sequence of tasks to efficiently achieve the goal.
I can develop a strategic plan to reduce costs in the department.
I am good at planning for the "unexpected".
I understand what equipment will be needed for the project.

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.