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
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Prepares for unexpected contingencies.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes action without being asked.
Takes the initiative to change the direction or course of events.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates a consistent process for prioritizing work.
Defines roles, rights, and responsibilities of the team.
Holds team accountable to meeting goals.
Acts like an owner when they make decisions.
Is someone you can trust.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters an environment built upon trust.
Accepts responsibility for mistakes.
Follows tasks to completion.
Establishes relationships of trust, honesty, fairness, and integrity.
Demonstrates honesty and truthfulness at all times.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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.
Does not allow own emotions to interfere with the performance of others.
Uses patience and self-control in working with customers and associates.
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
Constantly enhances product knowledge through experimentation and play.
Critiques own performance and learns from experience as a source of continuous improvement.
Takes initiative for own learning and development.
Demonstrates through personal behavior the commitment to high standards of performance.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains good working relationships with employees.
Resolves personnel problems quickly and effectively.
Encourages employees to achieve their full potential.
Delegates effectively.
Appropriately recognizes and rewards employees.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies problems and issues needing resolution.
Asks the "right" questions to size up or evaluate situations.
Implements data validation techniques and methods.
Selects the appropriate techniques for analysis.
Identifies the root cause of a problem.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to make decisions quickly.
Asks for additional information when making critical decisions.
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
Does not lose sight of the big picture when making decisions
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains positive customer relationships.
Does not hesitate to address customer concerns or complaints.
Consistently models positive customer service attitudes.
Develops strong customer relationships.
Considers customers point of view when making decisions.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Attends [Company] gatherings and social events.
Impresses upon others the important aspects of [Company].

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: