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
Works quickly when faced with difficult problems.
Does whatever it takes (within reason) to get the job done.
Displays high energy and enthusiasm on consistent basis.
Effectively makes decisions
Gets the job 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.
Views diversity as a strength, not as an issue.
Recognizes individual and cultural differences.
Respects the views offered by individuals with different cultural backgrounds.
Understands how their own cultural background can impact the way they communicate and interact with others.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Measures performance of goals and objectives.
Ensures employees understand the goals of the organization/department.
Prioritizes the work of others.
Aligns individual and team goals with the organization's goals and objectives.
Recognizes and values good performance.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works effectively during periods of change.
Can handle changes without complaining.
Encourages others to adopt new procedures.
Adapts to circumstances as needed.
Is open to alternative ways to accomplish goals
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts with urgency when time is limited.
Acts quickly to address any issues or problems.
Seizes upon chances to improve the department's prospects.
Completes tasks without having to be told to do so.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Stays focused on meeting the needs of customers.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Does not become distracted by non-issues or interruptions.
Helps others when free-time is available.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is honest in all communication with the customers.
Takes the initiative in solving difficult customer issues.
Creates new and innovative products for customers.
Makes sure team members understand the issues faced by the customer.
Delivers customized solutions for each customer.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees through recognition of positive changes in behavior.
Provides constructive feedback to others.
Creates a work environment that fosters positive feedback to employees.
Is open to receiving feedback.
Tries to ensure employees are ready to move to the next level.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Partners with peers to obtain influence within the Company.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Supports and encourages relationships that are created by diverse team members.
Supports a partnering/networking culture.
Creates the conditions for partnerships to grow and develop.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands how decisions impact other business units beyond their immediate department of work group.

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: