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
Is open to change and adjusts plans when needed.
Accommodates changes as needed.
Adjusts plans to meet new situations.
Easily accepts new responsibilities.
Adjusts priorities to changing business goals.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to adapt to new situations.
Willing to try new ideas.
Adapts to circumstances as needed.
Encourages others to adopt new procedures.
Implements changes as a result of having listened to employees
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages risk taking and experimentation to improve performance
Conveys a sense of urgency about addressing problems and opportunities
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
Willing to work with employees who have different cultural backgrounds.
Recognizes and values individual and cultural differences.
Acknowledges their own biases in cultural interactions.
Views diversity as a strength, not as an issue.
Values the diverse perspectives from others.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Listens and responds to issues and problems
Works effectively in the department.
Effectively organizes resources and plans
Sets a high standard for job performance.
Effective in performing his/her job.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Finds creative ways to get things done with limited resources.
Actively seeks the root cause of a problem.
Implements effective solutions to critical problems.
Identifies and assesses all potential responses to a problem.
Works cooperatively with others to solve problems.
Excellence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Produces high quality work.
Demonstrates the analytical skills to do their job.
Keeps themselves and others focused on constant improvement.
Can be counted on to add value wherever they are involved.
Takes a lot of pride in their work.
Client Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Anticipates resources needed to meet the client needs.
Prioritizes client issues to tackle the most pressing needs first.
Builds trust with the client.
Creates innovative solutions to meet client needs.
Consistently meets client's needs.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Discusses conflict situations with supervisor.
Clearly expresses expectations to others.
Identifies and takes steps to prevent potential confrontations.
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
Able to influence others to accept certain positions.
Able to say "no" when it is essential to maintaining quality and high standards.
Maintains good interpersonal relationships with representatives from the other party.
Conducts necessary preparations before engaging in negotiations.
Is able to decline bad ideas to avoid making poor decisions.
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates goals and objectives to employees.
Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
Able to decline a poor strategy by proposing alternate strategies.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.

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: