Initiative - 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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Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Informs the manager of any important changes in the equipment operation.
Acts quickly when an opportunity becomes available.
Is proactive when preparing for potential problems or critical events.
Builds strong interpersonal relationships upon first meeting.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds employees responsible if expectations are not met.
Takes responsibility for the team's actions and results.
Acknowledges errors and takes the steps necessary to rectify them.
Fully embraces the responsibilities that contribute to our departmental success.
Takes personal responsibility for the quality of their work.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Protects the integrity and confidentiality of information
Demonstrates sincerity in actions with others.
Does what was promised.
Maintains strong relationships with others.
Fosters an environment built upon trust.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does not allow own emotions to interfere with the performance of others.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
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.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Exhibits willingness to upgrade skills through additional training and education.
Embraces new technology and procedures.
Stays up-to-date on emerging technologies.
Constantly enhances product knowledge through experimentation and play.
Is committed to enhancing their own knowledge and skills.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conveys instructions, directives and guidelines to the employees.
Fosters a culture of personal responsibility and accountability.
Intervenes immediately if disciplinary action is warranted.
Effectively determines which issues need immediate attention.
Makes sure employees are working toward goals set by the company.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies the root cause of a problem.
Analyzes data and information from several sources and arrives at logical conclusions.
Implements data validation techniques and methods.
Uses appropriate techniques to solve problems.
Asks the "right" questions to size up or evaluate situations.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Carefully evaluates information before making an important decision.
Examines for patterns in data to help predict future possibilities.
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Receptive to new ideas from others when making decisions.
Is open to listening to others who may have different ideas.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts to changes proposed by the customer.
Makes sure team members understand the issues faced by the customer.
Creates an environment that enables customers to receive excellent service.
Exceeds expectations of the customers.
Anticipates potential obstacles to meeting customer needs.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows existing procedures and processes.
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.

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: