Establishing Focus/Direction - 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.

---

Establishing Focus/Direction	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains self-control when personally criticized.
Makes sure that employees understand and identify with the team's mission.
Excellent at managing time.
Stays focused even when under pressure and stress.
Functions well under stress, deadlines, and/or significant workloads.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops a good rapport with others.
Attempts to persuade others rather than simply control them.
Seeks to obtain consensus or compromise.
Understanding what others need.
Persuades others to consider alternative points of view.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accepts accountability for their actions and results.
Implements and facilitates controls and processes that maintain the integrity of the organization.
Is aware of problems or issues that may affect the organization.
Defines roles, rights, and responsibilities of employees.
Acts like an owner when they make decisions.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to influence others.
Takes ownership and accountability for results
Effectively leads others.
Gives direct, constructive, and actionable feedback.
Demonstrates leadership and courage in critical situations.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works well in this position.
Has great overall performance
Effective in performing his/her job.
Shown significant improvement in job performance.
...Overall Performance
Quality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyze what occurred and re-adjusts accordingly when goals are not met.
Reflects on what is working and what could be improved.
Corrects issues in a timely manner.
Encourages others to achieve high quality standards.
Holds employees accountable for their quality of work.
Time Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets clearly defined goals.
Prioritizes tasks to identify immediate and long-term objectives.
Leaves time in the schedule for unplanned contingencies.
Prioritizes new tasks according to their relative importance.
Keeps and maintains a To-Do list.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes immediate action toward goals.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Maintains persistence and dedication to achieving results.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Able to focus on a task even when working alone.
Entrepreneurship	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Excellent at managing relationships with stakeholders.
Encourages dynamic growth opportunities.
Has a strategic awareness on how to promote the organization.
Finds unique ways to go around barriers to success.
Devotes a certain amount of time and effort to developing new business opportunities.

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

    -Excellent -Good -Average -Poor




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


48. 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?
    
    
    


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


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


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


52. 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: