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
Completed required training and certification.
Takes calculated risks.
Sets challenging goals.
Sets challenging goals for the department.
Increased revenue for the company.
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.
Coordinates all department activities into a cohesive team effort.
Encourages commitment in others to obtain results.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports safety programs and procedures.
Seeks to reduce the likelihood of accidents.
Participates in safety training when available.
Keeps accurate safety records.
Develops a sustainable safety culture.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Experiments with new ideas to create innovative solutions to issues.
Is flexible in their approach to dealing with unpredictable events.
Can seamlessly transition between various environments and situations.
Changes strategies based on new information.
Demonstrates adaptability in innovative thought processes.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conveys a sense of urgency about addressing problems and opportunities
Seeks and utilizes opportunities for continuous learning and self-development.
Displays high energy and enthusiasm on consistent basis.
Completes work on time
Encourages risk taking and experimentation to improve performance
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Functions effectively within various cultural contexts.
Seeks to reduce obstacles in communication that might arise from cultural differences.
Is aware of differences in how individuals from other cultures greet one another.
Recognizes individual and cultural differences.
Communicates with others without the influence of racism.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands how to develop critical and analytical thinking.
Maintains precision when collecting and measuring data.
Selects the appropriate techniques for analysis.
Can effectively interpret and analyze data.
Recognizes that all parts of a business are connected where a change in one area can impact others in unexpected ways.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Cleans the workspace without being told.
Anticipates problems and initiates plans to address them.
Builds strong interpersonal relationships upon first meeting.
Acts quickly when a small problem arises to keep it from becoming a major issue.
Immediately works to complete goals well before their deadline.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees to consider opportunities to innovate processes and products.
Supports innovation at all levels of the organization.
Empowers employees with the technical skills essential for driving innovation and achieving strategic goals.
Establishes measurable innovation goals and regularly track progress to maintain focus and momentum.
Adequately funds innovation efforts to ensure their success.

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: