Continual Improvement - 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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Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Looks for ways to improve work processes and procedures.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Analyzes processes to determine areas for improvement.
Open to the suggestions from others.
Looks for ways to expand current job responsibilities.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to manage their own emotions.
Is able to express themselves clearly.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shows consistency between what they say and do.
Instructs employees on the proper way to perform tasks.
Maintains an even temper in stressful situations.
Decides what supplies need to be purchased.
Encourages good working relationships between employees.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Listens and responds to issues and problems
Works effectively in the department.
Shown significant improvement in job performance.
Effective in performing his/her job.
Has great overall performance
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to new ideas and innovations.
Adjusts strategy when new information is presented.
Adjusts plans and procedures.
Able to adapt to changes in technology and processes.
Adjusts tactics when things are not working as expected.
Quality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates quality standards that are easily by employees.
Holds employees accountable for their quality of work.
Communicates with team members regarding best quality practices.
Is flexible in addressing issues related to quality.
Establishes timeframes for achieving suitable quality levels.
Time Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets goals to complete specific parts of the project by certain times to keep on schedule.
Continues working on the most important tasks until they are completed.
Completes high-priority work within required timelines.
Tackles major tasks or problems first before addressing minor issues.
Able to keep to the project schedule.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accepts accountability for their actions and results.
Willingly accepts the consequences for their actions.
Accepts personal responsibility for the timeliness of work.
Informs supervisor of progress without having to be asked about it.
Accepts personal responsibility for producing high quality and timely work.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to focus on a task even when working alone.
Committed to the team.
Encourages commitment in others to obtain results.
Takes immediate action toward goals.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assigns tasks and responsibilities to develop skills of others.
Recognizes and celebrates accomplishments of others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Assesses employees' developmental needs.
Creates a work environment that fosters positive feedback to employees.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Reorders the schedule of events to maximize attendance/efficiency.
Ensures staff have the supplies and resources necessary to enact the plan.
Develops strategic plans for the company/organization.
Identifies resource requirements that may impact the development of the 5-year plan.
Assigns the right tasks to the right people and holds them accountable.

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

    -Excellent -Good -Average -Poor




57. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
58. 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?
    
    
    
59. What changes do you see [Company] making in order to raise the standards?
    
    
    
60. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
61. What do you like best about working for [Company]?
    
    
    
62. 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: