Initiative - 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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Initiative	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I will continue to work on a problem even in the face of obstacles.
You escalate strategically when necessary to unblock stalled efforts, while maintaining professionalism.
I act quickly when a small problem arises to keep it from becoming a major issue.
You take action without being asked.
You take on extra projects after required work is completed.
Commitment	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I actively engage each team member to ensure they personally endorse the initiative.
You secure commitment from team members.
You take immediate action toward goals.
You encourage commitment in others to obtain results.
I mobilize individual commitment to the success of the department.
Conflict Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I seek to achieve mutually acceptable outcomes.
You persuade others to accept personal transformation.
You are able to persuade and influence others.
You identify areas of agreement and common ground.
I ensure that both parties work toward finding compromise.
Self Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You use patience and self-control in working with customers and associates.
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
You consciously control own negative emotions in order to keep team morale up.
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You review organizational conditions to uncover strategic opportunities and mitigate potential threats.
I establish processes and structure to steer the organization in a clear, strategic direction.
I plan responses to potential risks or unforeseen challenges to minimize disruption.
You distinguish between minimum acceptable performance and aspirational excellence.
I set production assignments for the department.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You design effective quality control systems.
You expect employees to produce high quality products.
You investigate critical incidents that impact quality.
I lead the department in quality improvement initiatives.
I provide advice and guidance to team members on improving quality controls.
Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You quantify the discrepancy between expected outcomes and measures of performance.
You implement effective solutions to critical problems.
I ensure that team members have the necessary training and are informed about best practices and procedures.
You collect relevant information and data.
I adapt to different problems by applying a wide range of strategies and techniques.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You identify verbal and nonverbal cues to help interpret actions and messages.
You find shared interests and solutions that benefit all parties involved.
You establish good working relationships with others.
You adapt strategies to better meet the needs of the moment.
I maximize information gathering efforts prior to negotiations.
Recognition	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You use a systematic approach to implementing recognition programs.
I accompany recognition with specific examples of how the employee's work makes a difference for the department/organization.
You recognize team members who offer a significant contribution to a project.
You recognize the team at the end of long/difficult projects.
You implement performance bonuses in a fair manner.
Entrepreneurship	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to adapt the department to changing business demands and climate.
You are excellent at managing relationships with stakeholders.
You understand the processes and various stages of business development.
You can work effectively in an environment of uncertainty.
You take the initiative to complete tasks.

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

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

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