Delegation - 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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Delegation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Entrusts subordinates with important tasks.
Assigns tasks to create learning opportunities for the employees.
Clearly defines duties and tasks to be completed.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a high standard for job performance.
Works effectively in the department.
Effective in performing his/her job.
Shown significant improvement in job performance.
Able to organize work.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Chooses integrity over convenience.
Defines roles, rights, and responsibilities of employees.
Takes charge of addressing and solving problems.
Accepts personal responsibility for their actions.
Consults with the supervisor before engaging in new procedures that have some risk.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows tasks to completion.
Establishes relationships of trust, honesty, fairness, and integrity.
Develops trust and confidence from others.
Maintains strong relationships with others.
Accepts responsibility for mistakes.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Exhibits willingness to upgrade skills through additional training and education.
Will participate in training classes even if offered outside of normal working hours.
Is open minded and curious about learning new skills.
Embraces new technology and procedures.
Is open to feedback from others.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures stakeholders are involved in the decision making process.
Persuades others to consider alternative points of view.
Has excellent influencing/negotiating skills.
Seeks to obtain consensus or compromise.
Attempts to persuade others rather than simply control them.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes reports on-time.
Takes responsibility for decisions.
Able to develop, justify and present a budget.
Enthusiastic about taking on challenging projects.
Strong organizational skills to keep the workspace and department in order
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the root causes of problems.
Finds creative ways to get things done with limited resources.
Skilled at quickly diagnosing issues, identifying root causes, and developing and implementing effective solutions in the workplace.
Effective in solving problems.
Ability to develop innovative solutions to problems.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Resolves grievances through a better understanding and appreciation of what each side needs.
Clearly expresses expectations to others.
Avoids being judgmental and micromanaging of employees.
Actively engages both parties to voluntarily collaborate and resolve their differences.
Facilitates dialog between team members.
Entrepreneurship	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains a high level of energy to respond to demands of the job.
Has a strategic awareness on how to promote the organization.
Takes the initiative to complete tasks.
Seeks and utilizes mentors to help guide professional development.
Exhibits determination and passion in completion of goals.

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: