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
Facilitates change with minimal resistance.
Develops plans for following through on the changes.
Is an inspiration for others to accept the recent changes.
Assists others in understanding changes to the organization.
Is a leading force driving changes.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Demonstrates mastery of the technical competencies required in his/her work.
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Is knowledgeable of procedures or systems necessary for the job.
Seeks information from others as needed.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of changes to team personnel.
Adapts to changes in team membership.
Adjusts plans and procedures.
Adjusts tactics and strategies.
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Upholds ethical standards even when no one is watching.
Keeps supervisor informed of recent events.
Takes full responsibility for unmet expectations and makes corrective actions immediately.
Takes charge of addressing and solving problems.
Consults with the supervisor before engaging in new procedures that have some risk.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to manage their own emotions.
Accurately perceives the emotional reactions of others.
Able to understand others' points of view.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters an environment that supports open communication.
Facilitates team members working well together.
Is fair and equitable in enforcement of work rules.
Shows consistency between what they say and do.
Ensures employees know what they need to complete during the shift.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Selects the appropriate techniques for analysis.
Implements data validation techniques and methods.
Analyzes data and information from several sources and arrives at logical conclusions.
Prioritizes various actions to be taken when solving a problem.
Identifies opportunities for progress and innovation.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is a good problem solver and decision maker
Identifies and assesses all potential responses to a problem.
Generates alternative solutions to problems and challenges.
Understands the root causes of problems.
Actively seeks the root cause of a problem.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Utilizes partners' key strengths to create mutual advantages.
Implements effective oversight of network activities.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Reinforces the contacts with other organizations.
Builds trust with colleagues and coworkers.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Establishes a course of action for self and others to accomplish specific goals.
Identifies resource requirements that may impact the development of the 5-year plan.
Able to develop logistics plans to move material through a multi-step supply chain.
Plans for how to allocate time to specific activities.
Always has a "Plan-B" ready if needed.

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: