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
Takes the initiative and does not wait for the situation to change.
Takes responsibility for actions.
Takes corrective action when necessary.
Addresses performance issues quickly.
Fixes problems when they occur.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of the similarities and differences among and between cultural groups.
Respects others regardless of age, race, gender, nationality, or disability.
Values the diverse perspectives from others.
Accepts individual differences.
Understands the impact that our culture may have on interactions between individuals.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures employees understand how work is to be completed.
Addresses poor performance sooner rather than later.
Ensures employees understand their performance expectations.
Clearly articulates the performance requirements for the position.
Holds employees accountable for meeting performance expectations.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts to new organizational structures, policies, or procedures.
Encourages others to adopt new procedures.
Adapts to circumstances as needed.
Open to the perspectives/viewpoints of others.
Effective in incorporating new ideas.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Initiates new projects for the department.
Takes the initiative to change the direction or course of events.
Seeks and utilizes opportunities for continuous learning and self-development.
Does things without being told.
Completes tasks without having to be told to do so.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Motivated by a strong desire to exceed performance standards.
Completes urgent tasks first.
Helps others when free-time is available.
Gives extra effort to solve problems and get work done on time.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Anticipates customer needs.
Interacts with customers to define roles, expectations, and responsibilities.
Manages customer accounts with high degree of competence.
Transparent in all communications with the customer.
Helps customers to feel satisfied with our work/services.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the successes of other employees.
Creates opportunities for professional development.
Recognizes and celebrates accomplishments of others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Assigns tasks and responsibilities to develop skills of others.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Supports a partnering/networking culture.
Creates the conditions for partnerships to grow and develop.
Maintains infrastructure to support partnerships and networks.
Seeks an understanding of diverse functions within the Company.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Attends [Company] gatherings and social events.
Understands the "basics" as to how [Company] functions/operates.
Understands the use of [Company] products and services.
Understands how decisions impact other business units beyond their immediate department of work group.
Follows existing procedures and processes.

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: