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 seek to mitigate grievances by clarifying intentions and finding suitable remedies.
You are trustworthy; is someone that can be trusted.
You demonstrate congruence between statements and actions.
You work in a way that makes others want to work with you.
You communicate an understanding of the other person's interests, needs and concerns.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You encourage employees to take on greater responsibilities.
You tackle issues head on and finds solutions.
I expect employees to account for their actions and performance.
I acknowledge errors and take the steps necessary to rectify them.
You hold yourself and others accountable for meeting the deadline.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop trust and confidence from others.
You maintain strong relationships with others.
You accept responsibility for mistakes.
You demonstrate honesty and truthfulness at all times.
You demonstrate sincerity in actions with others.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You participate in regular training offered.
You share best practices with others and learn from others.
You grasp new ideas, concepts, technical, or business knowledge.
You set relevant learning objectives and goals.
You pursue self-improvement through continual learning.
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 and identify with the team's mission.
You are excellent at managing time.
You set appropriate goals for employees.
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 established goals.
You make sure that team members have a clear idea of our group's goals.
You set challenging stretch goals
You understand and contribute to development of strategic goals.
You achieve goals.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are committed to the team.
You maintain persistence and dedication to achieving results.
You are able to focus on a task even when working alone.
You take immediate action toward goals.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You know where to stand firm and where to compromise.
You aim for solutions that benefit both parties.
I develop a unified understanding or strategy that acknowledges and addresses the different viewpoints and resolves conflicts.
I understand the other person's needs, concerns, and motivations.
You are able to say "no" when it is essential to maintaining quality and high standards.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
I exploit resources and capabilities to strategically increase production and responsiveness.
You create a SWOT matrix to help analyze data.
You ensure that the department's goals are strategically aligned with the company's goals.
You identify bottlenecks in the production process and develops strategies to correct these issues.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You attend [Company] gatherings and social events.
You understand the use of [Company] products and services.
You understand the "basics" as to how [Company] functions/operates.
You follow existing procedures and processes.
You understand how decisions impact other business units beyond your immediate department of work group.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to look ahead (beyond the present) when addressing the work/needs of the department.
I can create a timeline for events and monitors progress.
I identify resource requirements that may impact the development of the 5-year plan.
You have developed an effective strategic plan.
You are open to input from others into the plan 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.