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
Assigns tasks to create learning opportunities for the employees.
Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Allows employees to decide how they wish to complete the tasks.
Defines goals and objectives for subordinates.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has great overall performance
Shown significant improvement in job performance.
Sets a high standard for job performance.
Works well in this position.
...Produce Quality
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fully embraces the responsibilities that contribute to our departmental success.
Accepts personal responsibility for not meeting expectations.
Handles sensitive information with discretion and confidentiality.
Takes full responsibility for unmet expectations and makes corrective actions immediately.
Takes responsibility for the direction of the team.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates honesty and truthfulness at all times.
Develops trust and confidence from others.
Maintains strong relationships with others.
Protects the integrity and confidentiality of information
Follows tasks to completion.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates an environment that supports personal development and exploration.
Stays up-to-date on emerging technologies.
Embraces new technology and procedures.
Holds self and associates accountable for goal achievement.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
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.
Seeks to obtain consensus or compromise.
Persuades others to consider alternative points of view.
Able to express own goals and needs.
Develops a good rapport with others.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes reports on-time.
Enthusiastic about taking on challenging projects.
Accurately implements contract provisions.
High attention to detail.
Implements and uses performance measures.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is a good problem solver and decision maker
Ability to solve problems at root cause rather than at symptom level.
Identifies and assesses all potential responses to a problem.
Solves problems using logic and insight.
Makes judgments based upon relevant information.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Combines ideas and viewpoints of different team members.
Values the diverse perspectives of others.
Does not let minor issues escalate into major problems.
Creates an environment where team members work collaboratively rather than compete with one another.
Facilitates dialog between stakeholders.
Entrepreneurship	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks and utilizes mentors to help guide professional development.
Balances risks and rewards when making decisions.
Able to adapt the department to changing business demands and climate.
Exhibits determination and passion in completion of goals.
Encourages risk taking for developing potential business opportunities.

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: