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 the Company's efforts to implement changes.
Is a leading force driving changes.
Is an inspiration for others to accept the recent changes.
Effective in dealing with ambiguous and challenging situations.
Able to get department employees to accept new changes.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
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.
Knows how to produce high quality products/work.
Is knowledgeable of procedures or systems necessary for the job.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Handles unexpected events without a loss of productivity.
Learns from personal experiences and/or mistakes.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Handles changes easily.
Able to respond to incidents without stopping the workflow.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to complete required tasks on time and delivered expected results.
Keeps supervisor informed of recent events.
Informs the supervisor if progress on the task has been delayed.
Takes full responsibility for team's lack of progress.
Lets supervisor know of any setbacks to the progress on achieving goals.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accurately perceives the emotional reactions of others.
Able to understand others' points of view.
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to express themselves clearly.
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
Informs employees of what tasks need to be completed on each shift.
Oversees the work of a group of employees.
Determines the training and development needs of employees and staff.
Oversees employees to make sure their work is performed up to standard.
Maintains an even temper in stressful situations.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains high attention to detail to ensure tests/experiments are replicable and results are reliable.
Selects the solution that offers the best outcome based on the analysis.
Presents data clearly and concisely to support strong, evidence-based arguments.
Able to interpret and analyze data.
Determines the relevance and accuracy of information.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Selects the solution that best addresses the problem's objectives, aligns with business priorities, and is feasible to implement.
Assesses the extent to which proposed solutions would lead to success.
Implements the ongoing tracking of key metrics and indicators to ensure the solution continues to perform as expected.
Implements solutions and evaluates results.
Creates a project plan to implement the solution and collects all required resources.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Facilitates open and honest communication to build trust and mutual respect.
Forms strategic alliances with firms that specialize in areas that are complementary or help the company.
Regularly attends conferences and seminars to meet with others in the industry.
Works in tandem with colleagues to pursue common goals and needs.
Supports and encourages relationships that are created by diverse team members.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Makes plans and follows through.
Open to input from others into the plan for development of the strategic plan.
Determines what supplies/equipment will be needed for the project.
Determines staffing needs for the project/department.
Develops proper plans to ensure seamless flow of materials through logistics.

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: