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
Demonstrates the functional or technical skills necessary to do their job.
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Can be counted on to add value wherever they are involved.
Is planful and organized.
Creativity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adds value to the department/organization.
Develops solutions to challenging problems.
Conceives, implements and evaluates ideas.
Inspires creativity in their team.
Is creative.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses patience and self-control in working with customers and associates.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Consciously controls own negative emotions in order to keep team morale up.
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates an environment that supports personal development and exploration.
Enjoys learning new skills and techniques.
Takes initiative for own learning and development.
Demonstrates a willingness to participate in continuing education courses.
Constantly enhances product knowledge through experimentation and play.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Functions effectively within various cultural contexts.
Develops skills and attitudes to bridge cultural differences.
Open to learning about different cultures.
Is open and honest in communications with individuals from other cultures.
Is sensitive to the similarities and differences that exist between cultures.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Initiates large projects.
Prepares and utilizes QC Checklists to ensure high quality.
Locates the equipment and supplies needed for the project.
Documents the risk assessments for different parts of the project.
Develops performance measures for various aspects of the project.
Trustworthy	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is trustworthy; is someone I can trust.
Builds and maintains the trust of others.
Takes care to maintain confidential information.
Communicates an understanding of the other person's interests, needs and concerns.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Developing Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes and celebrates accomplishments of others.
Supports the successes of other employees.
Provides constructive feedback to others.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Is open to receiving feedback.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures that both parties work toward finding compromise.
Explores the feasibility of alternative solutions to resolve conflicts.
Seeks to reduce the scarcity of limited resources by sourcing materials from new locations.
Works with others as needed to facilitate resolution of conflicts.
Persuades others to accept personal transformation.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the efforts of other employees in implementing solutions to problems.
...treats others with respect and dignity.
Includes others in the decision making processes.
Consistently demonstrates ability and willingness to trust others.
Able to see issues from others' perspectives.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
Impresses upon others the important aspects of [Company].

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: