Innovation - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

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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Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You implement best practices within the department.
You create a safe environment for idea-sharing.
You analyze current procedures and identify opportunities for improvement.
You build upon the ideas and solutions of others.
You search for opportunities and innovative ways to improve the organization.
Collaboration	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You respect other group/team members.
You identify and organize partnerships and alliances.
You create a culture that fosters and values collaboration.
You display a high degree of trust and credibility.
You readily share information with other group members.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You communicate a clear message that teamwork and collaboration are expected.
You contribute to and supports team decision-making process
You build relationships across boundaries and with key stakeholders by developing informal and formal networks.
You encourage teamwork and collaboration.
You create opportunities to learn with other team members
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
You are proactive and takes steps to prepare for changes in the workplace.
You work effectively in dynamic and changing work environments.
You are flexible and open to new ideas and encourages others to value change.
You recognize and implement changes to enhance efficiency and effectiveness.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You implement data validation techniques and methods.
You select the appropriate techniques for analysis.
You identify the root cause of a problem.
You analyze issues and reduces them to your component parts.
You identify problems and issues needing resolution.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You coordinate all department activities into a cohesive team effort.
You are able to focus on a task even when working alone.
You take immediate action toward goals.
You encourage commitment in others to obtain results.
You are committed to the team.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You convey a sense of urgency about addressing problems and opportunities
You complete a large volume of work.
You motivate others to achieve or exceed goals
You display high energy and enthusiasm on consistent basis.
You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You participate in safety training when available.
You support safety programs and procedures.
You develop a strong safety culture.
You are aware of osha safety guidelines.
You identify and addresses safety needs.

41. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


43. 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?
    
    
    


44. What changes do you see [Company] making in order to raise the standards?
    
    


45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


46. What do you like best about working for [Company]?
    
    


47. 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: