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.
Maintains strong relationships with others.
Demonstrates sincerity in actions with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops skills and attitudes to bridge cultural differences.
Understands how their own cultural background can impact the way they communicate and interact with others.
Seeks out different viewpoints and benefits from different perspectives.
Engages with individuals that have different cultural backgrounds.
Recognizes individual and cultural differences.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Works well in this position.
...Produce Quality
Effective in performing his/her job.
Works effectively in the department.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Open to the perspectives/viewpoints of others.
Able to adapt to new situations.
Encourages others to adopt new procedures.
Is open to alternative ways to accomplish goals
Adapts to new organizational structures, policies, or procedures.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes work on time
Encourages risk taking and experimentation to improve performance
Seeks and utilizes opportunities for continuous learning and self-development.
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Displays high energy and enthusiasm on consistent basis.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates solutions to problems as soon as an incident occurs.
Updates the documentation as soon as the situation changes.
Takes the initiative to change the direction or course of events.
Is proactive and gets things done.
Acts quickly when a small problem arises to keep it from becoming a major issue.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides clear expectations for employees.
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Stays focused on meeting the needs of customers.
Does not become distracted by non-issues or interruptions.
Helps others when free-time is available.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Applies complex rules and regulations to maintain optimal system performance.
Adopts the implementation of new technology into the workplace.
Uses technology in decision making and problem solving.
Supports employee training and development initiatives regarding implementation of technology.
Supports technical training and development of employees.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a good example.
Behavior is ethical and honest.
Sets a good example
Holds herself / himself accountable to goals / objectives
Acts as a resource without removing individual responsibility.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Set clear goals for assignments.
Encourages others to obtain necessary skills and training.
Distributes the workload to subordinates.
Provides support and resources needed to accomplish goals.
Recognizes the accomplishments of employees when they complete important assignments.
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Finds opportunities to recognize others.
Compliments other people when they do good work
Lets employees know when they have done well
Recognizes the abilities and skills of self and others
Reinforces and rewards employees for accomplishing necessary goals.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the use of [Company] products and services.
Impresses upon others the important aspects of [Company].
Expresses loyalty and dedication to [Company] in interactions with others.
Attends [Company] gatherings and social events.
Follows existing procedures and processes.

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: