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
Successfully launched the ABC project.
Leverages key performance indicators (KPIs) to track results and adjust strategies for optimal outcomes.
Maintains high performance standards.
Helps others to improve or meet standards of performance.
Cuts through red tape to enhance efficiency and remove unnecessary hurdles.
Commitment	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Elevates accountability from obligation to ownership, ensuring employees commit because they believe in the value of their role.
Redirects attention back to core commitments when conversations or tasks drift off course.
Builds a culture where employees embrace shared values as the foundation for productivity.
Invites team members to make explicit commitments that can be tracked and revisited.
Committed to the team.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Performs work safely.
Creates accurate and effective measures of safety.
Participates in safety training when offered.
Commits adequate resources toward safety measures.
Supports our company's safety programs.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies new opportunities to achieve goals
Is flexible in solving difficult problems.
Adapts training delivery to enhance effectiveness and create an inclusive environment, boosting team cohesion and productivity.
Responds to changing governmental regulations.
Responds to diverse challenges.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes personal responsibility for managing the necessary actions.
Initiates tasks or projects that address identified needs.
Exhibits personal ambition and drive.
Driven to get things done.
Uses time management to focus on the most critical tasks and allocate time effectively to ensure they are completed.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Avoids referring to stereotypes about others from different cultures.
Participates in cultural training sessions/classes.
Supports and mentors others that may have different cultural backgrounds.
Respects others regardless of age, race, gender, nationality, or disability.
Understands what customs and etiquette are important for individuals from other cultures.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses a more analytical and careful approach to solving issues.
Identifies the root cause of a problem.
Has a solid grasp of basic research methodologies.
Uses appropriate techniques to solve problems.
Maintains high attention to detail to ensure tests/experiments are replicable and results are reliable.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does things without being told.
Acts with urgency when time is limited.
Persists in stakeholder engagement even when initial outreach is met with resistance or indifference.
Does the right thing without being told.
Takes on extra projects after required work is completed.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes the competitive environment to determine where innovation would have the greatest impact.
Serves as an effective innovative champion.
Ensures the workforce maintains cutting-edge technical competencies to support continuous innovation and growth.
Facilitates ongoing technical training and development to enable employees to contribute to innovative solutions.
Participates in cross-functional innovation teams.

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: