Excellence - 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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Excellence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps themselves and others focused on constant improvement.
Can be counted on to add value wherever they are involved.
Demonstrates the analytical skills to do their job.
Is planful and organized.
Takes a lot of pride in their work.
Creativity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conceives, implements and evaluates ideas.
Is creative and inspirational.
Creates a lot of new ideas.
Is creative.
Develops solutions to challenging problems.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Uses patience and self-control in working with customers and associates.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Exhibits willingness to upgrade skills through additional training and education.
Demonstrates through personal behavior the commitment to high standards of performance.
Takes initiative for own learning and development.
Will participate in training classes even if offered outside of normal working hours.
Is open minded and curious about learning new skills.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Interacts effectively with people from different cultural backgrounds.
Participates in cultural training sessions/classes.
Is responsive to individuals from other cultures.
Is curious and willing to ask questions about the cultural differences in the workplace.
Recognizes individual and cultural differences.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps stakeholders informed of progress on the project.
Holds meetings with supply-chain vendors regarding acquisition of resources.
Ensures work is completed to the appropriate standards.
Procures the resources necessary to complete the project.
Estimates the duration for each phase of the project.
Trustworthy	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is trustworthy; is someone I can trust.
Demonstrates congruence between statements and actions.
Builds and maintains the trust of others.
Communicates an understanding of the other person's interests, needs and concerns.
Takes ownership, delivers on commitments
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to receiving feedback.
Sets performance objectives for subordinates that encourages development opportunities.
Provides constructive feedback to others.
Tries to ensure employees are ready to move to the next level.
Recognizes and celebrates accomplishments of others.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assists team members by helping them see the other point of view.
Discusses conflict situations with supervisor.
Deals effectively with employee grievances.
Helps employees to think through alternative ways to resolve conflict situations.
Clearly expresses expectations to others.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to see issues from others' perspectives.
Supports the efforts of other employees in implementing solutions to problems.
Works effectively with people from other departments.
Forms working relationships with employees from other departments.
Constructively receives criticism and suggestions from others.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.

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: