Bias for 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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Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes work on time
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Displays high energy and enthusiasm on consistent basis.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Encourages risk taking and experimentation to improve performance
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to adopt new procedures.
Identifies new opportunities to achieve goals
Open to the perspectives/viewpoints of others.
Adapts to circumstances as needed.
Able to adapt to new situations.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Handles unexpected events without a loss of productivity.
Adjusts priorities to changing business goals.
Will stop what they are doing to help colleagues in need.
Handles changes easily.
Learns from personal experiences and/or mistakes.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in performing his/her job.
Shown significant improvement in job performance.
Listens and responds to issues and problems
Able to organize work.
Effectively organizes resources and plans
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ability to solve problems at root cause rather than at symptom level.
Understands the root causes of problems.
Generates alternative solutions to problems and challenges.
Works cooperatively with others to solve problems.
Effective in solving problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Initiates projects that have an impact on the department.
Acts on own initiative to improve the department outcomes.
Takes the initiative to solve pressing issues.
Encourages others on the team to suggest process improvements.
Takes on extra projects after required work is completed.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes all assigned tasks.
Focuses on achieving important goals.
Does not become distracted by non-issues or interruptions.
Creates measures of performance to track progress.
Completes work on time.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Interacts effectively with people from different cultural backgrounds.
Views diversity as a strength, not as an issue.
Hires individuals with different cultural backgrounds for the department.
Functions effectively within various cultural contexts.
Effective in working with individuals with a variety of cultural backgrounds.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates value within the Company by building networks.
Creates the conditions for partnerships to grow and develop.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Partners with peers to obtain influence within the Company.
Forges mutually beneficial relationships between individuals with diverse backgrounds.

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

    -Excellent -Good -Average -Poor




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


48. 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?
    
    
    


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


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


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


52. 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: