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

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Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are trustworthy; is someone that can be trusted.
You communicate an understanding of the other person's interests, needs and concerns.
You demonstrate congruence between statements and actions.
You deliver on promises made.
You work in a way that makes others want to work with you.
Accountability	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I regularly complete tasks on time.
You understand the importance of holding employees accountable for their work.
I expect employees to account for their actions and performance.
You are someone who is trustworthy.
You consult with the supervisor before engaging in new procedures that have some risk.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You maintain strong relationships with others.
You foster a high standard of ethics and integrity.
You protect the integrity and confidentiality of information
You foster an environment built upon trust.
You develop trust and confidence from others.
Continual Learning	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You pursue self-improvement through continual learning.
You pursue learning that will enhance job performance.
You participate in regular training offered.
You seek opportunities to grow in skills and knowledge.
You set relevant learning objectives and goals.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are excellent at managing time.
You make sure that employees understand and identify with the team's mission.
You stay focused even when under pressure and stress.
You maintain self-control when personally criticized.
You maintain focus when handling several problems or tasks simultaneously.
Goals	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You make sure that team members have a clear idea of our group's goals.
You set high expectations and goals; encourages others to support the organization.
You establish and document goals and objectives.
You understand and contribute to development of strategic 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 create a sense of urgency among the store team members to complete activities, which drive sales.
You are able to focus on a task even when working alone.
You maintain persistence and dedication to achieving results.
You coordinate all department activities into a cohesive team effort.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You actively listen to conversations to be able to recall important details later.
I always have a "game plan" prior to entering into negotiations.
You persuade the other party of the benefits of our proposals.
I understand the other person's needs, concerns, and motivations.
You adapt strategies to better meet the needs of the moment.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I develop strategies that are practical and can be feasibly implemented within a reasonable period of time.
I ensure adherence to the strategy to sustain achievement of targeted levels of organizational performance.
I create measures of performance and profitability to assess financial objectives.
You create a mission statement describing the purpose for the organization.
I create a vision for the organization based on how the organization should appear in the future.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You express loyalty and dedication to [Company] in interactions with others.
You understand the use of [Company] products and services.
You impress upon others the important aspects of [Company].
You follow existing procedures and processes.
You understand the "basics" as to how [Company] functions/operates.
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.
You set the appropriate sequence of tasks to efficiently achieve the goal.
I am able to stay organized and focused using excellent planning skills.
You are able to closely follow the plan established for the department.
I anticipate the impacts of strategic plans.

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.