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 attentive to emotional cues and interprets others' feelings correctly.
Is able to control their own emotions.
Able to understand others' points of view.
Accurately perceives the emotional reactions of others.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Listens and responds to issues and problems
Sets a high standard for job performance.
...Overall Performance
...Produce Quality
Effectively organizes resources and plans
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts to changes in team membership.
Adjusts tactics and strategies.
Accommodates changes as needed.
Adjusts tactics when things are not working as expected.
Will stop what they are doing to help colleagues in need.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Encourages risk taking and experimentation to improve performance
Motivates others to achieve or exceed goals
Identifies ways to simplify work processes and reduce cycle times
Seeks and utilizes opportunities for continuous learning and self-development.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ability to solve problems at root cause rather than at symptom level.
Able to respond swiftly to keep the problem-solving process moving forward without unnecessary delays.
Is flexible and adjusts the solution as needed based on the monitoring data and feedback received.
Optimizes resource utilization, reducing waste and maximizing efficacy of the solutions implemented.
Assigns individuals the responsibility for completing separate phases of the implementation.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Immediately works to complete goals well before their deadline.
Cleans the workspace without being told.
Engages with new customers immediately.
Completes tasks without having to be told to do so.
Updates the documentation as soon as the situation changes.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps track of progress toward the results.
Sets important goals for the department.
Achieves high levels of performance.
Is considered a high achiever.
Strives to achieve high volume of output.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Actively participates as a team member
Creates opportunities to learn with other team members
Helps other team members to research solutions to a problem.
Fosters an environment that promotes active listening on the team.
Coaches team members to work toward a common goal.

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: