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 an environment built upon trust.
Fosters a high standard of ethics and integrity.
Develops trust and confidence from others.
Demonstrates sincerity in actions with others.
Demonstrates honesty and truthfulness at all times.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages a work environment where individual differences are valued.
Hires individuals with different cultural backgrounds for the department.
Is curious and willing to ask questions about the cultural differences in the workplace.
Participates in cultural training sessions/classes.
Treats others with dignity and respect.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Sets a high standard for job performance.
Able to organize work.
...Produce Quality
...Overall Performance
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works effectively during periods of change.
Identifies new opportunities to achieve goals
Encourages others to adopt new procedures.
Effective in incorporating new ideas.
Acts decisively in frequently changing and uncertain environment.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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).
Seeks and utilizes opportunities for continuous learning and self-development.
Displays high energy and enthusiasm on consistent basis.
Encourages risk taking and experimentation to improve performance
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to initiate work on projects independently without direct supervision.
Independently seeks out new learning opportunities to improve their skills.
Acts independently to solve pressing needs.
Analyzes the needs of the situation and acts before being told to do so.
Informs the manager of any important changes in the equipment operation.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a common goals for the team.
Encourages employees to give 100% to achieving high results.
Sets the objectives for the team.
Has a work ethic with a strong desire to obtain results.
Helps the team maintain focus on the goals.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adopts the implementation of new technology into the workplace.
Supports technical training and development of employees.
Proficient in the use of technical systems and processes.
Maximizes the use of new technology to deliver products and services.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Responsible for setting the vision of the department.
Sets a good example
Is a person you can trust.
Works in a way that makes others want to work with her/him.
Acts as a resource without removing individual responsibility.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willing to share in the decision making process.
Acknowledges and appreciates employees for their proactive decision-making.
Distributes the workload to subordinates.
Values the expertise that others bring to the team.
Motivates and encourages employees to be successful in their jobs.
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Reinforces and rewards employees for accomplishing necessary goals.
Recognizes team members who offer a significant contribution to a project.
Readily shares credit and gives others opportunity for visibility.
Recognizes the abilities and skills of self and others
Is sincerely interested in the suggestions of co-workers
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands how decisions impact other business units beyond their immediate department of work group.
Impresses upon others the important aspects of [Company].
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the "basics" as to how [Company] functions/operates.

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: