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.

---

Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Addresses small problems before they become big ones.
Initiates important conversation topics at meetings.
Does the right thing without being told.
When working on a problem in a team, they are often the first to suggest possible solutions.
Engages with new customers immediately.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accepts accountability for their actions and results.
Takes ownership of mistakes and learns from them.
Acts like an owner when they make decisions.
Is aware of problems or issues that may affect the organization.
Defines roles, rights, and responsibilities of the team.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accepts responsibility for mistakes.
Does what was promised.
Protects the integrity and confidentiality of information
Fosters an environment built upon trust.
Maintains strong relationships with others.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses patience and self-control in working with customers and associates.
Analyzes interpersonal problems instead of reacting to them.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Steps away from a situation to process appropriate response.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Stays up-to-date on emerging technologies.
Inspires others to learn new things.
Creates an environment that supports personal development and exploration.
Demonstrates a willingness to participate in continuing education courses.
Is committed to enhancing their own knowledge and skills.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to remain calm in tense situations.
Determines the training and development needs of employees and staff.
Listens to others.
Conducts regular progress meetings to ensure adherence to the schedule.
Understands the importance of good performance management.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes issues and reduces them to their component parts.
Identifies opportunities for progress and innovation.
Identifies the root cause of a problem.
Prioritizes various actions to be taken when solving a problem.
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
Makes decisions based on novel interpretations of the facts.
Applies creative reasoning in making decisions.
Is aware of the impact of decisions and informs others about potential outcomes.
Formulates imaginative decisions.
Uses reasonable assumptions and logic to decide between alternate courses of action
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Tailors innovative products for each customer.
Exceeds expectations of the customers.
Is competent in handling customer cases.
Ensures customers' expectations are met or exceeded.
...friendliness and courtesy
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Expresses loyalty and dedication to [Company] in interactions with others.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.
Attends [Company] gatherings and social events.

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: