Integrity - 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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Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters a high standard of ethics and integrity.
Establishes relationships of trust, honesty, fairness, and integrity.
Develops trust and confidence from others.
Demonstrates honesty and truthfulness at all times.
Does what was promised.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Treats others with dignity and respect.
Encourages a work environment where individual differences are valued.
Recognizes and values individual and cultural differences.
Shows respect in daily interactions
Seeks out different viewpoints and benefits from different perspectives.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a high standard for job performance.
Listens and responds to issues and problems
Works effectively in the department.
Shown significant improvement in job performance.
Has great overall performance
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to adopt new procedures.
Willing to try new ideas.
Adapts to circumstances as needed.
Able to adapt to new situations.
Works effectively during periods of change.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes a large volume of work.
Encourages risk taking and experimentation to improve performance
Conveys a sense of urgency about addressing problems and opportunities
Motivates others to achieve or exceed goals
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Prepares for unexpected contingencies.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Seeks and utilizes opportunities for continuous learning and self-development.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes the initiative to change the direction or course of events.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides clear expectations for employees.
Stays focused on meeting the needs of customers.
Works toward achievement of goals even when confronted with obstacles.
Does not become distracted by non-issues or interruptions.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Proficient in the use of technical systems and processes.
Applies complex rules and regulations to maintain optimal system performance.
Uses technology in decision making and problem solving.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Understands and is committed to implementing new technologies.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts as a resource without removing individual responsibility.
Works in a way that makes others want to work with her/him.
...takes personal responsibility for results.
Is a person you can trust.
Behavior is ethical and honest.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Avoids micromanaging their employees.
Sets clear goals for others to accomplish.
Provides support and resources needed to accomplish goals.
Distributes the workload to subordinates.
Allows individuals to be responsible for their decisions.
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Finds opportunities to recognize others.
Recognizes individuals for a specific outstanding achievement.
Compliments other people when they do good work
Reinforces and rewards employees for accomplishing necessary goals.
Recognizes team members who offer a significant contribution to a project.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Understands the use of [Company] products and services.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.

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

    -Excellent -Good -Average -Poor




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


63. 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?
    
    
    


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


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


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


67. 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: