Adaptability - 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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Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes and implements changes to enhance efficiency and effectiveness.
Flexible and open to new ideas and encourages others to value change.
Develops insights and applies innovative solutions to projects and problems.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Able to quickly learn new ways of performing their job.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to alternative ways to accomplish goals
Works effectively during periods of change.
Open to the perspectives/viewpoints of others.
Adapts to new organizational structures, policies, or procedures.
Adapts to circumstances as needed.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Displays high energy and enthusiasm on consistent basis.
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Completes work on time
Motivates others to achieve or exceed goals
Seeks and utilizes opportunities for continuous learning and self-development.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Seeks out different viewpoints and benefits from different perspectives.
Respects others regardless of age, race, gender, nationality, or disability.
Encourages a work environment where individual differences are valued.
Fosters a diverse workforce free from discrimination and harassment.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Works effectively in the department.
Listens and responds to issues and problems
Has great overall performance
...Produce Quality
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to balance the needs of different people in a solution to a problem.
Works cooperatively with others to solve problems.
Identifies and assesses all potential responses to a problem.
Ability to develop innovative solutions to problems.
Solves problems using logic and insight.
Excellence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is planful and organized.
Demonstrates the analytical skills to do their job.
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Can be counted on to add value wherever they are involved.
Client Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is pro-active in dealing with clients and addressing their needs.
Maintains strong relationships with clients.
Satisfies client needs.
Obtains feedback to ensure client needs are being met.
Looks for opportunities that have a positive impact on Clients.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.
Clearly expresses expectations to others.
Helps employees to think through alternative ways to resolve conflict situations.
Tries to understand others' point of view before making judgments
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Establishes clear communications to avoid misunderstandings.
Influences others through rational argument and persuasion.
Identifies verbal and nonverbal cues to help interpret actions and messages.
Able to influence others to accept certain positions.
Able to say "no" when it is essential to maintaining quality and high standards.
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Understands & contributes to development of strategic goals.
Communicates goals and objectives to employees.
Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
Looks for opportunities to enhance contributions to the bottom line.

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

    -Excellent -Good -Average -Poor




57. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


58. 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?
    
    
    


59. What changes do you see [Company] making in order to raise the standards?
    
    


60. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


61. What do you like best about working for [Company]?
    
    


62. 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: