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
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Motivates others to achieve or exceed goals
Identifies ways to simplify work processes and reduce cycle times
Conveys a sense of urgency about addressing problems and opportunities
Encourages risk taking and experimentation to improve performance
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts to circumstances as needed.
Able to adapt to new situations.
Implements changes as a result of having listened to employees
Willing to try new ideas.
Works effectively during periods of change.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Flexible and open to new ideas and encourages others to value change.
Is flexible and open minded in dealing with others.
Recognizes and implements changes to enhance efficiency and effectiveness.
Develops insights and applies innovative solutions to projects and problems.
Able to work effectively with new people and new teams.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has great overall performance
Effective in performing his/her job.
Able to organize work.
Sets a high standard for job performance.
Works effectively in the department.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works cooperatively with others to solve problems.
Solves problems using logic and insight.
Ability to develop innovative solutions to problems.
Is a good problem solver and decision maker
Effective in solving problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Goes above and beyond the stated goals.
Immediately works to complete goals well before their deadline.
Seeks and utilizes opportunities for continuous learning and self-development.
Takes the initiative to change the direction or course of events.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works toward achievement of goals even when confronted with obstacles.
Helps others when free-time is available.
Does not become distracted by non-issues or interruptions.
Stays focused on meeting the needs of customers.
Explains the "whys" behind organizational objectives
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shows respect in daily interactions
Encourages a work environment where individual differences are valued.
Fosters a diverse workforce free from discrimination and harassment.
Treats others with dignity and respect.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Creates value within the Company by building networks.
Seeks to reduce institutional roadblocks to information sharing.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Develops a sense of trust in subordinates so they can freely interact and share information with others.

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: