Engagement- 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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Engagement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures that employees have clearly defined goals for their job.
Loves coming to work each day.
Values contributions of employees during discussions.
Regularly keeps employees informed of important changes.
Provides employees with support.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adjusts plans or decisions based on employee feedback when appropriate.
Motivates and encourages employees to be successful in their jobs.
Recognizes and rewards employees who make important decisions and take action when necessary.
Values the expertise that others bring to the team.
Values the opinions of others.
Communication Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Approachable, dependable, and ready to assist when needed.
Faces the person when speaking or listening to engage in direct communication.
Responds to questions with accurate and complete answers
Communicates effectively with all levels of the organization.
Conveys important reports with a sense of excitement, passion, and urgency.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds self and associates accountable for goal achievement.
Enjoys learning new skills and techniques.
Is open minded and curious about learning new skills.
Takes advantage of training opportunities when they arise.
Demonstrates through personal behavior the commitment to high standards of performance.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes the initiative to learn new skills.
Builds on their strengths while addressing their weaknesses.
Takes charge of their training and skills enhancement.
Pursues learning that will enhance job performance.
Improves on their skill sets.
Critical Thinking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates disciplined reasoning when comparing alternatives.
Asks targeted questions to resolve uncertainty and ensure data is interpreted accurately.
Able to consider multiple perspectives and potential explanations.
Able to 'read between the lines' and 'see under the surface'.
Examines personal biases and assumptions before forming conclusions.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates a safe environment for idea-sharing.
Encourages disruptive innovation allowing managers to identify and seize opportunities that traditional approaches might overlook.
Seeks innovative ways to change, grow, and improve the department.
Challenges current procedures / processes to develop new solutions.
Promotes disruptive innovation empowering managers to challenge the status quo and push the boundaries of what's possible.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to work safely.
Develops a culture of safety.
Ensures that all supervisors are aware of regulatory and compliance measures.
Is aware of OSHA safety guidelines.
Encourages others to attend safety training.
Client Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Prioritizes client issues based on urgency.
Has received good feedback from clients.
Manages client accounts with high degree of competence.
Addresses client complaints immediately.
Provides a high level of service to clients.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is willing to include individuals with different cultural backgrounds on the team.
Adapts communication style to respect cultural norms and preferences of team members.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Publicly acknowledges cultural contributions and achievements in team settings.
Consistently acknowledges and validates the contributions of team members from all backgrounds.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Formulates the schedule for the project phases, resources usage, and benchmarks.
Anticipates potential problems and institutes controls and contingency plans to address them.
Works with customers and clients to assess their needs and define project parameters.
Coordinates timelines, events and tasks with various sub-groups within the project.
Successfully negotiated contracts with suppliers.

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: