Goals - 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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Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Achieves established goals.
Makes sure that team members have a clear idea of our group's goals.
Achieves goals.
Makes sure that I have a clear idea of our group's goals.
Understands & contributes to development of strategic goals.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willing to do whatever it takes-not afraid to have to put in extra effort.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Takes immediate action toward goals.
Encourages commitment in others to obtain results.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Participates in safety training as applicable.
Works to implement corrective safety measures.
Commits adequate resources toward safety measures.
Encourages others to work safely.
Develops a culture of safety.
Responsible	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.
Is a person you can trust.
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Sets a good example.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Establishes clear communications to avoid misunderstandings.
Establishes good working relationships with others.
Able to influence others to accept certain positions.
Is able to decline bad ideas to avoid making poor decisions.
Identifies verbal and nonverbal cues to help interpret actions and messages.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works effectively in dynamic and changing work environments.
Develops insights and applies innovative solutions to projects and problems.
Is proactive and takes steps to prepare for changes in the workplace.
Recognizes and implements changes to enhance efficiency and effectiveness.
Able to quickly learn new ways of performing their job.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes a large volume of work.
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Seeks and utilizes opportunities for continuous learning and self-development.
Motivates others to achieve or exceed goals
Conveys a sense of urgency about addressing problems and opportunities
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Respects others regardless of age, race, gender, nationality, or disability.
Treats others with dignity and respect.
Recognizes and values individual and cultural differences.
Values the opinions of diverse groups and individual.
Encourages a work environment where individual differences are valued.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements data validation techniques and methods.
Uses appropriate techniques to solve problems.
Selects the appropriate techniques for analysis.
Balances risks and costs with the rewards and probabilities of success when decisions.
Asks the "right" questions to size up or evaluate situations.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks and utilizes opportunities for continuous learning and self-development.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes the initiative to change the direction or course of events.
Goes above and beyond the stated goals.
Takes action without being asked.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements best practices within the department.
Builds upon the ideas and solutions of others.
Encourages open communication to ensure that all proposals are considered.
Suggests new ideas at meetings.
Analyzes current procedures and identifies opportunities for improvement.

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: