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
Uses established goals and performance measures to keep track of performance.
Completed training on the new equipment.
Holds others to high standards of achievement.
Increased customer satisfaction scores for the quarter.
Sets challenging goals for the department.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages commitment in others to obtain results.
Takes immediate action toward goals.
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.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports safety programs and procedures.
Develops safety guidelines for the department.
Supports our company's safety programs.
Points out behaviors in others that may be unsafe.
Keeps accurate safety records.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to increase output to meet increased demand.
Ability to cope with a variety of client needs.
Responds to the various needs of other colleagues and departments.
Encourages adaptability to utilize more efficient processes.
Adapts strategies to fit the specific needs of each situation.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Motivates others to achieve or exceed goals
Identifies ways to simplify work processes and reduce cycle times
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Conveys a sense of urgency about addressing problems and opportunities
Completes a large volume of work.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands how their own cultural background can impact the way they communicate and interact with others.
Willing to work with employees who have different cultural backgrounds.
Respects the views offered by individuals with different cultural backgrounds.
Values the diverse perspectives from others.
Supports and mentors others that may have different cultural backgrounds.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies the root cause of a problem.
Prioritizes various actions to be taken when solving a problem.
Implements data validation techniques and methods.
Analyzes issues and reduces them to their component parts.
Identifies opportunities for progress and innovation.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Initiates draft documents for the director.
Immediately informs the supervisor of any critical incidents.
Completes tasks without having to be told to do so.
Goes above and beyond the stated goals.
Takes on extra projects after required work is completed.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Searches for opportunities and innovative ways to improve the organization.
Creates a safe environment for idea-sharing.
Implements best practices within the department.
Takes risks to advance important ideas.
Develops new products and services.

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: