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
Produces high quality work.
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.
Takes a lot of pride in their work.
Is planful and organized.
Creativity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is creative.
Develops solutions to challenging problems.
Inspires creativity in their team.
Conceives, implements and evaluates ideas.
Adds value to the department/organization.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is committed to enhancing their own knowledge and skills.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Embraces new technology and procedures.
Is open to feedback from others.
Will participate in training classes even if offered outside of normal working hours.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages a work environment where individual differences are valued.
Acknowledges their own biases in cultural interactions.
Values the opinions of diverse groups and individual.
Fosters a diverse workforce free from discrimination and harassment.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops a plan for resource management.
Researches potential solutions to meet the constraints of the project.
Estimates the staffing requirements for the project.
Has the requisite industry knowledge to manage projects in this field.
Successfully negotiated contracts with suppliers.
Trustworthy	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates a sense of responsibility and commitment to public trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Delivers on promises made.
Demonstrates congruence between statements and actions.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets performance objectives for subordinates that encourages development opportunities.
Provides constructive feedback to others.
Creates opportunities for professional development.
Tries to ensure employees are ready to move to the next level.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Initates collaborative processes to reduce conflict.
Avoids being judgmental and micromanaging of employees.
Facilitates constructive dialog with stakeholders.
Able to settle disputes equitably.
Promotes openness and urges individuals to explore various options for resolving the conflict.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to see issues from others' perspectives.
Works across boundaries within the organization.
Able to see issues from others' perspectives.
...treats others with respect and dignity.
Consistently demonstrates ability and willingness to trust others.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows existing procedures and processes.
Understands the "basics" as to how [Company] functions/operates.
Understands how decisions impact other business units beyond their immediate department of work group.
Expresses loyalty and dedication to [Company] in interactions with others.
Attends [Company] gatherings and social events.

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: