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.

---

Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the Company's efforts to implement changes.
Facilitates change with minimal resistance.
Supports new initiatives for organizational changes to improve effectiveness.
Works cooperatively with others to implement changes.
Inspires others to want to change.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is knowledgeable of procedures or systems necessary for the job.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Willingly shares his/her technical expertise; sought out as resource by others
Knows how to produce high quality products/work.
Willingly shares information and expertise; sought out as resource by others
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to new ideas and innovations.
Responsive to the needs of others.
Is flexible when dealing with changes.
Learns from personal experiences and/or mistakes.
Is aware of changes to team personnel.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements and facilitates controls and processes that maintain the integrity of the organization.
Tackles issues head on and finds solutions.
Is someone you can trust.
Accepts accountability for their actions and results.
Holds team accountable to meeting goals.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to express themselves clearly.
Accurately perceives the emotional reactions of others.
Is able to control their own emotions.
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
Treats all staff equitably.
Encourages employees to achieve their full potential.
Shows consistency between what they say and do.
Delegates effectively.
Is respectful toward employees.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Prioritizes various actions to be taken when solving a problem.
Analyzes data and information from several sources and arrives at logical conclusions.
Balances risks and costs with the rewards and probabilities of success when decisions.
Uses appropriate techniques to solve problems.
Identifies problems and issues needing resolution.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Ability to develop innovative solutions to problems.
Finds creative ways to get things done with limited resources.
Effective in solving problems.
Makes judgments based upon relevant information.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports a partnering/networking culture.
Promotes the understanding of how the department affects the organization overall.
Builds alliances between departments and teams.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Creates value within the Company by building networks.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets the appropriate sequence of tasks to ensure completion of the project.
Effectively uses logistics planning to reduce supply delays.
Accurately estimates the duration of tasks.
Develops effective plans to deal with unforeseen circumstances.
Sets the appropriate sequence of tasks to efficiently achieve the goal.

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: