Emotional Intelligence - 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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Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to control their own emotions.
Is able to manage their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is attentive to emotional cues and interprets others' feelings correctly.
Accurately perceives the emotional reactions of others.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Works effectively in the department.
...Produce Quality
...Overall Performance
Works well in this position.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of changes to the policies and procedures.
Able to adjust to changes as needed.
Adapts to changes in team membership.
Effective in working with different personnel of the team.
Is open to changes in policies and procedures.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes a large volume of work.
Seeks and utilizes opportunities for continuous learning and self-development.
Completes work on time
Displays high energy and enthusiasm on consistent basis.
Encourages risk taking and experimentation to improve performance
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements effective solutions to critical problems.
Actively seeks the root cause of a problem.
Ability to develop innovative solutions to problems.
Understands the root causes of problems.
Works cooperatively with others to solve problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does the right thing without being told.
Encourages others on the team to suggest process improvements.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Initiates draft reports for consideration.
Gladly seeks additional responsibilities.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides clear expectations for employees.
Does not become distracted by non-issues or interruptions.
Stays focused on meeting the needs of customers.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Explains the "whys" behind organizational objectives
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes and respects the contributions and needs of each individual.
Act as an effective team player
Fosters respect and understanding among team members
Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
Creates a climate that encourages team participation.

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

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


43. 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?
    
    
    


44. What changes do you see [Company] making in order to raise the standards?
    
    


45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


46. What do you like best about working for [Company]?
    
    


47. 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: