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Passion to Learn - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey November

Dear Employee:
Questionnaires Measuring Passion to Learn:
You have been selected to provide feedback on the employee listed Survey 1 (4-point scale; Competency Comments)
above. Your feedback is an important part of our company's Survey 2 (4-point scale; Competency Comments)
leadership development process and this survey is intended to Survey 3 (5-point scale; Competency Comments)
gather broad feedback in the core competencies and role Survey 4 (5-point scale; radio buttons)
responsibilities that are important for the on-going success of our Survey 5 (4-point scale; words)
organization. Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
In responding to the questions below, think about your experiences Survey 8 (3-point scale; Agree/Disagree words; N/A)
working with this employee over the last twelve months. The Survey 9 (3-point scale; Strength/Development; N/A)
effectiveness of this development tool is dependent on your honest, Survey 10 (Comment boxes only)
forthright and constructive responses so please bear this in mind as Survey 11 (Single rating per competency)
you answer each question. Your responses will be aggregated with Survey 12 (Slide-bar scale)
the responses received from others and discussed with the employee Survey 13 (4-point scale; numbers; floating anchors)
to foster growth and on-going development. Survey 14 (4-point scale; N/A)

We
Competencies Included:
Passion To Learn, Continual Improvement, Professional
Development, Persuasion and Influence, Innovation,
Achievement, Excellence, Interpersonal Skills, Developing
Others, Business Acumen, Planning

encourage everyone to complete the survey. Please be honest,

constructive and thoughtful in your input. The survey is designed to Sample Result Document in PDF format:
help us understand more about your thoughts and needs to make 360-Feedback Results (pdf)
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 November 3 and November 16. 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

Needs Could benefit Capable

Significant from and Role
Passion To Learn Improvement Development Effective Model

Needs Could benefit Capable

1. Demonstrates through personal behavior the Role
Significant from and
commitment to high standards of performance. Model
Improvement Development Effective

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 2. Recognizes own areas for development and Needs Could benefit Capable
Role
consciously seeks assignments that will provide Significant from and
Model
practice in areas of developmental need. Improvement Development Effective

Needs Could benefit Capable

3. Holds self and associates accountable for goal Role
Significant from and
achievement. Model
Improvement Development Effective

Needs Could benefit Capable

4. Enhances value to the company through additional Role
Significant from and
training and development. Model
Improvement Development Effective

Needs Could benefit Capable

5. Constantly enhances product knowledge through Role
Significant from and
experimentation and play. Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Continual Improvement Improvement Development Effective Model

Needs Could benefit Capable

Role
6. Open to the suggestions from others. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

7. Looks for ways to expand current job Role
Significant from and
responsibilities. Model
Improvement Development Effective

Needs Could benefit Capable

8. Fosters a culture of open communication and Role
Significant from and
continuous improvement. Model
Improvement Development Effective

Needs Could benefit Capable

Role
9. Looks for ways to expand and learn new job skills. Significant from and
Model
Improvement Development Effective

10. Encourages an employee culture of continuous Needs Could benefit Capable

Role
improvement to seek out better ways of doing Significant from and
Model
things. Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Professional Development Improvement Development Effective Model

Needs Could benefit Capable

11. Allows employees to fully participate in employee Role
Significant from and
training and professional development. Model
Improvement Development Effective

Needs Could benefit Capable

Role
12. Seeks opportunities for continuous learning. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

13. Encourages employees to take courses relevant to Role
Significant from and
their job. Model
Improvement Development Effective

Needs Could benefit Capable

14. Demonstrate enthusiasm and a willingness to learn Role
Significant from and
new skills and knowledge Model
Improvement Development Effective
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 Needs Could benefit Capable
Role
15. Seeks opportunities for professional development. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Persuasion and Influence Improvement Development Effective Model

Needs Could benefit Capable

Role
16. Able to express own goals and needs. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

17. Takes a long-term view and acts as a catalyst and Role
Significant from and
champion of change. Model
Improvement Development Effective

Needs Could benefit Capable

Role
18. Works to persuade others. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

19. Translates complex technical or strategic issues into Role
Significant from and
accessible language that motivates action. Model
Improvement Development Effective

Needs Could benefit Capable

Role
20. Gains participation by others to accomplish goals. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Innovation Improvement Development Effective Model

21. Allows employees to dedicate time and resources

Needs Could benefit Capable
for innovation to empower them to think creatively Role
Significant from and
and contribute to the department's growth and Model
Improvement Development Effective
success.

Needs Could benefit Capable

Role
22. Has a strong commitment to innovation. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Role
23. Uses unconventional approaches to solve problems. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

24. Offers continuous learning opportunities to enhance Role
Significant from and
technical skills and innovative thinking. Model
Improvement Development Effective

Needs Could benefit Capable

25. Coordinates the activities of the innovation steering Role
Significant from and
committee. Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Achievement Improvement Development Effective Model

Needs Could benefit Capable Role

26. Increased production by 20 percent.
Significant from and Model
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 Improvement Development Effective

Needs Could benefit Capable

27. Eliminates bureaucratic barriers to streamline Role
Significant from and
processes. Model
Improvement Development Effective

Needs Could benefit Capable

28. Operates with relentless drive, consistently meeting Role
Significant from and
and surpassing deadlines. Model
Improvement Development Effective

29. Commits to methodical execution, ensuring Needs Could benefit Capable

Role
accountability and sustainable progress toward Significant from and
Model
objectives. Improvement Development Effective

Needs Could benefit Capable

Role
30. Demonstrates improvement in performance. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Excellence Improvement Development Effective Model

Needs Could benefit Capable

31. Can be counted on to add value wherever they are Role
Significant from and
involved. Model
Improvement Development Effective

Needs Could benefit Capable

Role
32. Produces high quality work. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Role
33. Is planful and organized. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

34. Keeps themselves and others focused on constant Role
Significant from and
improvement. Model
Improvement Development Effective

Needs Could benefit Capable

Role
35. Takes a lot of pride in their work. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Interpersonal Skills Improvement Development Effective Model

Needs Could benefit Capable

Role
36. Expresses appreciation of other's work. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

37. Uses tact, compassion, and sensitivity in interactions Role
Significant from and
with others. Model
Improvement Development Effective

Needs Could benefit Capable

38. Embraces the differences in individuals that Role
Significant from and
comprise the team. Model
Improvement Development Effective

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 Needs Could benefit Capable
39. Gives constructive feedback on performance Role
Significant from and
reviews. Model
Improvement Development Effective

Needs Could benefit Capable

Role
40. Recognizes when others do a good job. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Developing Others Improvement Development Effective Model

Needs Could benefit Capable

Role
41. Creates opportunities for professional development. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Role
42. Is open to receiving feedback. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

43. Encourages employees through recognition of Role
Significant from and
positive changes in behavior. Model
Improvement Development Effective

Needs Could benefit Capable

44. Recognizes and celebrates accomplishments of Role
Significant from and
others. Model
Improvement Development Effective

Needs Could benefit Capable

45. Develops employees by offering and encouraging Role
Significant from and
them to take on new or additional responsibilities. Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Business Acumen Improvement Development Effective Model

Needs Could benefit Capable

Role
46. Understands complex issues and problems. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

Role
47. Assists others in understanding business changes. Significant from and
Model
Improvement Development Effective

48. Involves key stakeholders (employees, customers, Needs Could benefit Capable
Role
investors, partners) in the planning process to gain Significant from and
Model
diverse perspectives and buy-in. Improvement Development Effective

Needs Could benefit Capable

49. Understands the financial metrics used by the Role
Significant from and
department. Model
Improvement Development Effective

Needs Could benefit Capable

50. Able to get department employees to accept new Role
Significant from and
business workflows. Model
Improvement Development Effective

Needs Could benefit Capable

Significant from and Role
Planning Improvement Development Effective Model
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 Needs Could benefit Capable
Role
51. Creates a timeline for events and monitors progress. Significant from and
Model
Improvement Development Effective

Needs Could benefit Capable

52. Ensures staff have the supplies and resources Role
Significant from and
necessary to enact the plan. Model
Improvement Development Effective

Needs Could benefit Capable

53. Divides complex tasks into smaller steps to measure Role
Significant from and
progress toward a goal. Model
Improvement Development Effective

Needs Could benefit Capable

54. Adjusts and rearranges the schedule to maximize Role
Significant from and
efficiency. Model
Improvement Development Effective

Needs Could benefit Capable

Role
55. Always has a "Plan-B" ready if needed. Significant from and
Model
Improvement Development Effective

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.

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