Accountability - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. 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

Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

---

Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes responsibility for results.
Keeps their word and does what they say they will do.
Holds team accountable to meeting goals.
Tackles issues head on and finds solutions.
Defines roles, rights, and responsibilities of the team.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Displays high energy and enthusiasm on consistent basis.
Completes work on time
Encourages risk taking and experimentation to improve performance
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes and implements changes to enhance efficiency and effectiveness.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Learns from personal experiences and/or mistakes.
Is flexible and open minded in dealing with others.
Is proactive and takes steps to prepare for changes in the workplace.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages a work environment where individual differences are valued.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Recognizes and values individual and cultural differences.
Fosters a diverse workforce free from discrimination and harassment.
Respects others regardless of age, race, gender, nationality, or disability.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses timely and appropriate corrective/disciplinary actions.
Measures performance against goals and objectives.
Prioritizes the work of others.
Reviews job performance shortly after completion of tasks.
Provides employees with necessary resources to accomplish their goals.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and assesses all potential responses to a problem.
Ability to develop innovative solutions to problems.
Ability to solve problems at root cause rather than at symptom level.
Able to balance the needs of different people in a solution to a problem.
Is a good problem solver and decision maker
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks and utilizes opportunities for continuous learning and self-development.
Immediately works to complete goals well before their deadline.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Prepares for unexpected contingencies.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works toward achievement of goals even when confronted with obstacles.
Stays focused on meeting the needs of customers.
Does not become distracted by non-issues or interruptions.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Inspires and motivates co-workers to be productive and energetic at work
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Says "thank you" to show appreciation for work of others.
Recognizes individuals for a specific outstanding achievement.
Compliments other people when they do good work
Offers recognition in a timely manner.
Makes people around them feel appreciated and valued.

46. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




47. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


48. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    


49. What changes do you see [Company] making in order to raise the standards?
    
    


50. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


51. What do you like best about working for [Company]?
    
    


52. What do you like least about working for [Company]? How could it be improved?
    


93. Use the space below to enter any final comments you would like to be noted: