Change Management - 360 Degree Feedback Survey Sample #6

Dear Employee:

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between and . 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

Change Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports the Company's efforts to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
Adopts changes to set and example for others to follow.
Effective in implementing new organizational vision and values.
Assists others in understanding changes to the organization.
Juggling Multiple Responsibilities	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Bounces back from daily crisis, disappointments and frustrations.
Plans and organizes continuously while performing all other responsibilities and activities.
Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Managing Risk	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Knows how to obtain desired results with minimal losses.
Seeks to retain the best and brightest employees.
Able to adapt quickly to changing situations.
Maintains open communication with other departments.
Recognizes that small changes may snowball into major events.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Develops a culture of safety.
Is not afraid to question a potential safety issue observed in the workplace.
Develops safety guidelines for the department.
Identifies predictable hazards in the workplace.
Participates in safety training as applicable.
Interpersonal Skills	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Successfully resolves conflicts and grievances to a win-win solution.
Is a role model for others
Provides constructive feedback in a way that fosters acceptance and development.
Effectively manages conflicts by dealing with them directly and immediately
Uses tact, compassion, and sensitivity in interactions with others.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Protects the integrity and confidentiality of information
Does what was promised.
Fosters a high standard of ethics and integrity.
Follows tasks to completion.
Establishes relationships of trust, honesty, fairness, and integrity.
Feedback	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Open to the suggestions of others.
Looks to others for input.
Shares past experiences with others as learning opportunities.
Seeks feedback to enhance performance.
Actively seeks feedback from others.
Client Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Satisfies client needs.
Forms strong client relationships
Looks for opportunities that have a positive impact on Clients.
Is pro-active in dealing with clients and addressing their needs.
Obtains feedback to ensure client needs are being met.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to decline bad ideas to avoid making poor decisions.
Able to say "no" when it is essential to maintaining quality and high standards.
Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
Influences others through rational argument and persuasion.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to see issues from others' perspectives.
Works effectively with people from other departments.
...treats others with respect and dignity.
Helpful
Forms working relationships with employees from other departments.
Company	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands how decisions impact other business units beyond their immediate department of work group.
Impresses upon others the important aspects of [Company].

56. Overall, please rate the effectiveness of .
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
57. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
58. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
59. Additional comments, if any for 's assessment.