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.
Demonstrates the functional or technical skills necessary to do their job.
Is planful and organized.
Produces high quality work.
Demonstrates the analytical skills to do their job.
Creativity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is creative and inspirational.
Creates a lot of new ideas.
Conceives, implements and evaluates ideas.
Adds value to the department/organization.
Inspires creativity in their team.
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.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Does not allow own emotions to interfere with the performance of others.
Uses patience and self-control in working with customers and associates.
Analyzes interpersonal problems instead of reacting to them.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is motivated by the desire to be "the best".
Critiques own performance and learns from experience as a source of continuous improvement.
Holds self and associates accountable for goal achievement.
Demonstrates through personal behavior the commitment to high standards of performance.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shows respect in daily interactions
Seeks out different viewpoints and benefits from different perspectives.
Respects others regardless of age, race, gender, nationality, or disability.
Treats others with dignity and respect.
Recognizes and values individual and cultural differences.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Anticipates potential problems and institutes controls and contingency plans to address them.
Responds quickly and appropriately to unforeseen problems.
Organizes, plans, and directs resources to accomplish the goals and objectives.
Regularly reviews project performance and goals.
Develops performance measures for various aspects of the project.
Trustworthy	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works in a way that makes others want to work with her/him.
Demonstrates congruence between statements and actions.
Communicates an understanding of the other person's interests, needs and concerns.
Consistently keeps commitments.
Demonstrates a sense of responsibility and commitment to public trust.
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.
Recognizes and celebrates accomplishments of others.
Creates opportunities for professional development.
Tries to ensure employees are ready to move to the next level.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and takes steps to prevent potential confrontations.
Tries to understand others' point of view before making judgments
Deals effectively with employee grievances.
Discusses conflict situations with supervisor.
Assists team members by helping them see the other point of view.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helpful
Constructively receives criticism and suggestions from others.
Able to see issues from others' perspectives.
Supports the efforts of other employees in implementing solutions to problems.
Works across boundaries within the organization.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the use of [Company] products and services.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.

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: