Change Management - 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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Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports new initiatives for organizational changes to improve effectiveness.
Supports the Company's efforts to implement changes.
Assists others in understanding changes to the organization.
Works cooperatively with others to implement changes.
Effective in implementing new organizational vision and values.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is knowledgeable of procedures or systems necessary for the job.
Seeks information from others as needed.
Willingly shares information and expertise; sought out as resource by others
Knows how to produce high quality products/work.
Willingly shares his/her technical expertise; sought out as resource by others
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops insights and applies innovative solutions to projects and problems.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Able to work effectively with new people and new teams.
Works effectively in dynamic and changing work environments.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps supervisor informed of recent events.
Develops goals and establishes objective measures of success.
Defines roles, rights, and responsibilities of employees.
Can be counted on to do what they say they are going to do.
Accepts accountability for their actions and results.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to express themselves clearly.
Able to understand others' points of view.
Is attentive to emotional cues and interprets others' feelings correctly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Delegates effectively.
Maintains good working relationships with employees.
Encourages employees to achieve their full potential.
Treats all staff equitably.
Appropriately recognizes and rewards employees.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes data and information from several sources and arrives at logical conclusions.
Identifies problems and issues needing resolution.
Balances risks and costs with the rewards and probabilities of success when decisions.
Selects the appropriate techniques for analysis.
Implements data validation techniques and methods.
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.
Identifies and assesses all potential responses to a problem.
Ability to develop innovative solutions to problems.
Able to balance the needs of different people in a solution to a problem.
Solves problems using logic and insight.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports and encourages relationships that are created by diverse team members.
Maintains infrastructure to support partnerships and networks.
Creates value within the Company by building networks.
Supports a partnering/networking culture.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Makes plans and follows through.
Works in an organized manner
Able to identify the needs of the department before a major change.
Able to look ahead (beyond the present) when addressing the work/needs of the department.

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

    -Excellent -Good -Average -Poor




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


53. 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?
    
    
    


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


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


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


57. 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: