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
Analyzes processes to determine areas for improvement.
Looks for ways to expand and learn new job skills.
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to manage their own emotions.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Is able to express themselves clearly.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of the unique strengths of each employee.
Appropriately recognizes and rewards employees.
Promotes teamwork and cooperation within the department.
Delegates effectively.
Encourages employees to achieve their full potential.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...Overall Performance
Able to organize work.
Sets a high standard for job performance.
Works effectively in the department.
Effective in performing his/her job.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Learns from personal experiences and/or mistakes.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Works effectively in dynamic and changing work environments.
Flexible and open to new ideas and encourages others to value change.
Is proactive and takes steps to prepare for changes in the workplace.
Quality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyze what occurred and re-adjusts accordingly when goals are not met.
Holds employees accountable for their quality of work.
Encourages others to achieve high quality standards.
Always strives to produce the highest quality work products.
Reflects on what is working and what could be improved.
Time Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does not procrastinate.
Deals effectively with interruptions.
Sets a good balance between work and family life.
Focuses on tasks that have high priority.
Makes time for developing plans and schedules.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of problems or issues that may affect the organization.
Develops goals and establishes objective measures of success.
Accepts accountability for their actions and results.
Keeps their word and does what they say they will do.
Acts like an owner when they make decisions.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Maintains persistence and dedication to achieving results.
Takes immediate action toward goals.
Coordinates all department activities into a cohesive team effort.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the successes of other employees.
Encourages employees through recognition of positive changes in behavior.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Tries to ensure employees are ready to move to the next level.
Creates opportunities for professional development.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Delegates role to team members to accomplish goals.
Able to identify the needs of the department before a major change.
Works in an organized manner
Makes plans and follows through.
Able to look ahead (beyond the present) when addressing the work/needs of the department.

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: