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 are trustworthy; is someone that can be trusted.
You work in a way that makes others want to work with you.
You demonstrate a sense of responsibility and commitment to public trust.
You build and maintain the trust of others.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop goals and establishes objective measures of success.
You define roles, rights, and responsibilities of the team.
You tackle issues head on and finds solutions.
You keep you supervisor informed of recent events.
You can be counted on to do what you say you are going to do.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You demonstrate sincerity in actions with others.
You foster an environment built upon trust.
You develop trust and confidence from others.
You establish relationships of trust, honesty, fairness, and integrity.
You foster a high standard of ethics and integrity.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You pursue learning that will enhance job performance.
You pursue self-improvement through continual learning.
You share best practices with others and learn from others.
You take the initiative to learn new skills.
You build on your strengths while addressing your weaknesses.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You align the department's goals with the goals of the organization.
You are excellent at managing time.
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 set appropriate goals for employees.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You achieve established goals.
You understand and contribute to development of strategic goals.
You set challenging stretch goals
You make sure that I have a clear idea of our group's goals.
You establish and document goals and objectives.
Commitment To Result	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain persistence and dedication to achieving results.
You coordinate all department activities into a cohesive team effort.
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.
You encourage commitment in others to obtain results.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You conduct necessary preparations before engaging in negotiations.
You leverage relationships with others to achieve goals.
You influence others through rational argument and persuasion.
You research the needs of the other party to identify strengths and weaknesses of positions.
You are able to adapt to changing situations.
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 focus attention on treating the causes of problems rather than simply addressing the symptoms.
You are able to decline a poor strategy by proposing alternate strategies.
You monitor performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
You understand and contribute to development of strategic goals.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You understand the "basics" as to how [Company] functions/operates.
You express loyalty and dedication to [Company] in interactions with others.
You understand the use of [Company] products and services.
You follow existing procedures and processes.
You attend [Company] gatherings and social events.
Planning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You determine what supplies/equipment will be needed for the project.
You ensure staff are held accountable for following the department plan.
I develop strategic plans for the company/organization.
I can develop a strategic plan to reduce costs in the department.
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.