Achievement - 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.

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Achievement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Increased customer satisfaction scores for the quarter.
Met required benchmarks for the position.
Takes calculated risks to achieve higher levels of performance.
Reduced department expenses by 25 percent.
Sets ambitious standards of performance.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Committed to the team.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Maintains persistence and dedication to achieving results.
Able to focus on a task even when working alone.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Committed to safety in the workplace.
Is aware of OSHA safety guidelines.
Mitigates hazards and safety issues that arise.
Encourages others to work safely.
Develops a culture of safety.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates innovative solutions to unforeseen problems.
Willing to change ideas or perceptions based on new information.
Is able to bounce back from obstacles.
Agile and versatile when responding to critical issues.
Capable of delivering a diverse range of goods and services to meet various business requirements.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Identifies ways to simplify work processes and reduce cycle times
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Encourages risk taking and experimentation to improve performance
Displays high energy and enthusiasm on consistent basis.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
May advocate for others with different cultural backgrounds.
Seeks to reduce obstacles in communication that might arise from cultural differences.
Develops skills and attitudes to bridge cultural differences.
Is willing to include individuals with different cultural backgrounds on the team.
Seeks knowledge and information about other cultures.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Balances risks and costs with the rewards and probabilities of success when decisions.
Analyzes data and information from several sources and arrives at logical conclusions.
Uses appropriate techniques to solve problems.
Identifies opportunities for progress and innovation.
Implements data validation techniques and methods.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Immediately informs the supervisor of any critical incidents.
Immediately works to complete goals well before their deadline.
Acts independently to solve pressing needs.
Takes the initiative to change the direction or course of events.
Prepares for unexpected contingencies.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Looks for opportunities to apply new and evolving technologies.
Encourages others to experiment and learn from their mistakes without fear of retribution.
Establishes measurable innovation goals and regularly track progress to maintain focus and momentum.
Optimizes the innovation process by incorporating feedback and lessons learned from previous experiences.
Uses innovation to solve urgent specific problems.

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: