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
Motivates others to achieve or exceed goals
Identifies ways to simplify work processes and reduce cycle times
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Encourages risk taking and experimentation to improve performance
Displays high energy and enthusiasm on consistent basis.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Open to the perspectives/viewpoints of others.
Works effectively during periods of change.
Can handle changes without complaining.
Is open to alternative ways to accomplish goals
Adapts to new organizational structures, policies, or procedures.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in working with different personnel of the team.
Able to step in and help co-workers when needed.
Is flexible and open minded in dealing with others.
Adjusts priorities to changing business goals.
Is aware of changes in the environment.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Sets a high standard for job performance.
Effective in performing his/her job.
Works well in this position.
...Overall Performance
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Solves problems using logic and insight.
Is a good problem solver and decision maker
Ability to solve problems at root cause rather than at symptom level.
Ability to develop innovative solutions to problems.
Able to balance the needs of different people in a solution to a problem.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts quickly when a small problem arises to keep it from becoming a major issue.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Takes the initiative to solve pressing issues.
Takes the initiative to complete tasks ahead of schedule.
Quickly comes to the aid of those who may need help.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Directs team in prioritizing daily work activities
Does not become distracted by non-issues or interruptions.
Stays focused on meeting the needs of customers.
Helps others when free-time is available.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates with others without the influence of racism.
Is willing to include individuals with different cultural backgrounds on the team.
Seeks out different viewpoints and benefits from different perspectives.
Is sensitive to the similarities and differences that exist between cultures.
Fosters a diverse workforce free from discrimination and harassment.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains infrastructure to support partnerships and networks.
Creates value within the Company by building networks.
Builds alliances between departments and teams.
Partners with peers to obtain influence within the Company.
Creates the conditions for partnerships to grow and develop.

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: