Flexibility - 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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Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willing to try new ideas.
Implements changes as a result of having listened to employees
Adapts to new organizational structures, policies, or procedures.
Open to the perspectives/viewpoints of others.
Can handle changes without complaining.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Is aware of changes to team personnel.
Responds quickly to new information.
Adjusts tactics and strategies.
Adjusts priorities to changing business goals.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Completes a large volume of work.
Completes work on time
Displays high energy and enthusiasm on consistent basis.
Seeks and utilizes opportunities for continuous learning and self-development.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands how implicit biases can affect decisions, communication and productivity.
Recognizes and values individual and cultural differences.
Seeks knowledge and information about other cultures.
Willing to work with employees who have different cultural backgrounds.
Is curious and willing to ask questions about the cultural differences in the workplace.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to express own goals and needs.
Develops a good rapport with others.
Communicates effectively with others.
Seeks to obtain consensus or compromise.
Understanding what others need.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to develop, justify and present a budget.
Completes reports on-time.
Implements and uses performance measures.
Has strong technical/computer skills.
Takes responsibility for decisions.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Does the right thing without being told.
Seeks and utilizes opportunities for continuous learning and self-development.
Anticipates problems and initiates plans to address them.
Able to initiate work on projects independently without direct supervision.
Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Inspires others to want to change.
Is an inspiration for others to accept the recent changes.
Works cooperatively with others to implement changes.
Assists others in understanding changes to the organization.
Effective in implementing new organizational vision and values.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Willingly shares his/her technical expertise; sought out as resource by others
Willingly shares information and expertise; sought out as resource by others
Seeks information from others as needed.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops a sustainable safety culture.
Works to implement corrective safety measures.
Performs work safely.
Participates in safety training as applicable.
Is not afraid to question a potential safety issue observed in the workplace.

51. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


53. 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?
    
    
    


54. What changes do you see [Company] making in order to raise the standards?
    
    


55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


56. What do you like best about working for [Company]?
    
    


57. 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: