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.
Is not afraid to take action when necessary.
Addresses safety issues immediately.
Is not afraid to take corrective action when necessary.
Is the first to volunteer for assignments.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Engages with individuals that have different cultural backgrounds.
Is sensitive to the similarities and differences that exist between cultures.
Participates in cultural training sessions/classes.
Fosters a diverse workforce free from discrimination and harassment.
Is willing to include individuals with different cultural backgrounds on the team.
Managing Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees to take additional training in areas where they had low performance scores.
Determines the Objectives and Key Results (OKRs) needed for the position.
Provides additional responsibilities for employees that exceed performance standards.
Conducts objectives and key results (OKR) assessments on a quarterly basis.
Rewards individuals who show imagination in developing creative solutions to problems.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shows a readiness to adapt and optimize.
Introduces new products or services.
Anticipates differences to the procedures that may be needed due to a changing operating environment.
Quickly adapts to new circumstances, challenges, or opportunities as they arise.
Creates personalized training schedules, offering various learning formats (like virtual and in-person sessions), and provides tailored training resources.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does the right thing without being told.
Completes tasks without having to be told to do so.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes corrective action to address performance deficiencies/issues.
Is proactive and gets things done.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works hard despite obstacles that impede progress.
Directs team in prioritizing daily work activities
Determines what resources will be needed to achieve the objectives.
Quickly analyzes the situation to determine the most pressing needs.
Strives to achieve high volume of output.
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.
Ensures commitments made to customers are completed to the customer's satisfaction.
Acts with integrity in all customer interactions.
Persistent in solving customer issues.
Considers customers point of view when making decisions.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets performance objectives for subordinates that encourages development opportunities.
Provides constructive feedback to others.
Tries to ensure employees are ready to move to the next level.
Assigns tasks and responsibilities to develop skills of others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Strives to cultivate and maintain a partnership based on trust and commitment in relationships.
Facilitates the formation of collaborative relationships with suppliers and vendors.
Ensures all participants in the network are treated fairly and equitably.
Facilitates cross-functional collaboration and information sharing between various stakeholders.
Seeks an understanding of diverse functions within the Company.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the use of [Company] products and services.
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.

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: