Action - 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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Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fixes problems when they occur.
Addresses performance issues quickly.
Does whatever it takes (within reason) to get the job done.
Takes action when opportunities arise.
Initiates actions to get things done.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is sensitive to the similarities and differences that exist between cultures.
Is open and honest in communications with individuals from other cultures.
Engages with individuals that have different cultural backgrounds.
Supports and mentors others that may have different cultural backgrounds.
Encourages a work environment where individual differences are valued.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Increases responsibilities for high performing individuals.
Ensures Job Descriptions are up to date and accurate.
Establishes measures of performance.
Implements remediation plans with follow up after 3 months.
Provides employees with training as needed to increase their performance.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Solves problems using innovative solutions by keeping an open mind and considering the input from others.
Willing to try new ideas.
Balances multiple perspectives to find common ground and innovative solutions.
Effective in incorporating new ideas.
Is open to and values diverse perspectives.
Initiative	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.
Able to initiate work on projects independently without direct supervision.
Expands the offerings of the department by working evenings and weekends.
Is an inspiration for others to perform above expectations.
Gladly seeks additional responsibilities.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Inspires and motivates co-workers to be productive and energetic at work
Flexible and willing to change the strategy to better achieve the objectives.
Prioritizes goals to complete those in urgent need first.
Concentrates efforts on the most urgent needs.
Achieves performance benchmarks.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures customers are comfortable with the services provided.
Responds to the needs of the customer.
Ensures customers' expectations are met or exceeded.
Uses feedback from the customer to help improve the customer's experience.
Has excellent communication with customers.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees through recognition of positive changes in behavior.
Creates opportunities for professional development.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Provides constructive feedback to others.
Assesses employees' developmental needs.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees to explore new partnership opportunities to expand market presence.
Is an active member of professional associations or professional groups to stay connected with peers.
Forms strategic alliances with firms that specialize in areas that are complementary or help the company.
Organizing team-building activities to strengthen bonds between colleagues.
Supports strategic alliances to combine strengths of both parties.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Expresses loyalty and dedication to [Company] in interactions with others.
Follows existing procedures and processes.
Understands the "basics" as to how [Company] functions/operates.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the use of [Company] products and services.

51. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
53. 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?
    
    
    
54. What changes do you see [Company] making in order to raise the standards?
    
    
    
55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
56. What do you like best about working for [Company]?
    
    
    
57. 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: