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.

---

Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Gets the job done.
Makes effective decisions, even when under pressure.
Is not afraid to take corrective action when necessary.
Drives and mobilizes others progress toward goals.
Does whatever it takes (within reason) to get the job done.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters a diverse workforce free from discrimination and harassment.
Seeks out different viewpoints and benefits from different perspectives.
Respects others regardless of age, race, gender, nationality, or disability.
Shows respect in daily interactions
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is consistent in disciplinary/corrective actions.
Uses timely and appropriate corrective/disciplinary actions.
Provides employees with necessary resources to accomplish their goals.
Makes sure commitments are understood and met.
Sets and maintains high standards for self and others.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Can handle changes without complaining.
Adapts to circumstances as needed.
Identifies new opportunities to achieve goals
Able to adapt to new situations.
Adapts to new organizational structures, policies, or procedures.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Immediately works to complete goals well before their deadline.
Prepares for unexpected contingencies.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Goes above and beyond the stated goals.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages a high-energy, fun work environment and coaches others on how to do the same
Explains the "whys" behind organizational objectives
Does not become distracted by non-issues or interruptions.
Inspires and motivates co-workers to be productive and energetic at work
Stays focused on meeting the needs of customers.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
Considers customers point of view when making decisions.
Consistently models positive customer service attitudes.
Maintains positive customer relationships.
...friendliness and courtesy
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates a work environment that fosters positive feedback to employees.
Creates opportunities for professional development.
Assigns tasks and responsibilities to develop skills of others.
Provides constructive feedback to others.
Sets performance objectives for subordinates that encourages development opportunities.
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.
Creates value within the Company by building networks.
Builds alliances between departments and teams.
Creates the conditions for partnerships to grow and develop.
Promotes the understanding of how the department affects the organization overall.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the "basics" as to how [Company] functions/operates.
Impresses upon others the important aspects of [Company].
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: