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
Completes tasks without having to be told to do so.
Initiates draft documents for the director.
Is proactive and gets things done.
Seizes upon chances to improve the department's prospects.
Goes above and beyond the stated goals.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Exhibits good governance in their role as an executive.
Reviews performance to determine areas for improvement.
Takes responsibility for seeing the project through to completion.
Takes responsibility for results.
Does not make excuses for being late for work.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Protects the integrity and confidentiality of information
Does what was promised.
Follows tasks to completion.
Maintains strong relationships with others.
Accepts responsibility for mistakes.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Consciously controls own negative emotions in order to keep team morale up.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Does not allow own emotions to interfere with the performance of others.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Embraces new technology and procedures.
Is open to feedback from others.
Is committed to enhancing their own knowledge and skills.
Creates an environment that supports personal development and exploration.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Promotes teamwork and cooperation within the department.
Contributes to a productive work environment for the team.
Is a calming force during stressful periods.
Provides constructive, ongoing feedback.
Holds employees accountable for work assignments.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Selects the appropriate techniques for analysis.
Implements data validation techniques and methods.
Identifies problems and issues needing resolution.
Uses appropriate techniques to solve problems.
Identifies opportunities for progress and innovation.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Makes good decisions for the department.
Understands how their decisions will affect others.
Views the long and short-term impact of decisions.
Maintains focus on the "big picture" when making decisions.
Examines for patterns in data to help predict future possibilities.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Prioritizes customer issues based on urgency.
Addresses customer complaints immediately.
Creates new and innovative products for customers.
Is committed to the customer's success.
Gets feedback from the customer on a weekly basis.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Attends [Company] gatherings and social events.
Follows existing procedures and processes.
Impresses upon others the important aspects of [Company].
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the use of [Company] products and services.

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: