Feedback - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

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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Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are visible and approachable.
You are easy to approach with ideas and opinions.
You look to others for input.
You ask others for their ideas and opinions.
You accept the views of others.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work well in this position.
You produce quality
You are able to organize work.
You listen and respond to issues and problems
You work effectively in the department.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I adapt strategies to fit the specific needs of each situation.
You are open to alternative ways to accomplish goals
I respond to changing governmental regulations.
You are willing to deviate from rigid plans and consider a variety of methods, ensuring the most effective solution is applied.
I pivot strategies, operations, or processes in real-time to meet new challenges or seize new opportunities.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to adjust plans to meet new situations.
You are able to adjust to changing environments.
You are proactive and takes steps to prepare for changes in the workplace.
You continually try to improve skills to remain current.
You develop insights and apply innovative solutions to projects and problems.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You complete work on time
You motivate others to achieve or exceed goals
You encourage risk taking and experimentation to improve performance
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You seek and utilize opportunities for continuous learning and self-development.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You can develop innovative solutions to problems.
You identify and assess all potential responses to a problem.
You implement effective solutions to critical problems.
You solve problems using logic and insight.
You are able to solve problems at root cause rather than at symptom level.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I complete all assigned tasks.
I complete all required coursework.
You are determined to complete tasks regardless of obstacles that may occur.
I identify what needs to be accomplished.
You are highly motivated to complete tasks despite obstacles that may arise.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You encourage others to attend safety training.
You develop safety guidelines for the department.
You work to implement corrective safety measures.
You participate in safety training as applicable.
You identify predictable hazards in the workplace.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I prioritize customer issues based on urgency.
You create innovative solutions to meet customer needs.
You make customer's needs a top priority.
I consistently meet customer's needs.
You ask questions and listen carefully to determine customer needs and to ensure that the customer's needs are met.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You facilitate the formation of collaborative relationships with suppliers and vendors.
You participate in conflict resolution to find mutually beneficial solutions.
I search for a common solution to shared problems or issues.
You identify partnerships with overseas companies to expand market opportunities.
You balance the strategic interests of those involved to maintain alliances.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I facilitate collaborative processes to reduce conflict.
You guide others toward establishing strong relationships.
I identify strategies to prevent the recurrence of issues.
I facilitate the resolution of grievances by fostering mutual understanding and appreciation of each party's needs.
I work to meet the basic needs of each side in the conflict.

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: