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
Created impactful reports for the re-organization committee.
Reduced department expenses by 25 percent.
Sets ambitious standards of performance.
Accepts setbacks and challenges as improvement opportunities
Sets performance metrics to measure achievement or attainment of goals.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Committed to the team.
Takes immediate action toward goals.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Performs work safely.
Encourages others to work safely.
Develops safety guidelines for the department.
Keeps accurate safety records.
Develops a culture of safety.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to alternative ways to accomplish goals
Identifies new opportunities to achieve goals
Effective in incorporating new ideas.
Able to adapt to new situations.
Acts decisively in frequently changing and uncertain environment.
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
Motivates others to achieve or exceed goals
Encourages risk taking and experimentation to improve performance
Completes work on time
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Participates in cultural training sessions/classes.
Seeks clarification to avoid misunderstandings.
Helps other employees to become more culturally sensitive.
Treats others with dignity and respect.
Values the diverse perspectives from others.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes data and information from several sources and arrives at logical conclusions.
Identifies the root cause of a problem.
Asks the "right" questions to size up or evaluate situations.
Selects the appropriate techniques for analysis.
Prioritizes various actions to be taken when solving a problem.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is a self-starter. Does not wait to be told to do something.
Helps the department take the initiative to create new solutions.
Guides strategic initiatives to advance the department/organization.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Acts with urgency when time is limited.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements best practices within the department.
Challenges current procedures to develop other alternatives.
Develops new products and services.
Fosters a creative and innovative work environment.
Offers constructive improvements to existing systems.

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: