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
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Protects the integrity and confidentiality of information
Demonstrates honesty and truthfulness at all times.
Develops trust and confidence from others.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Recognizes and values individual and cultural differences.
Values the opinions of diverse groups and individual.
Functions effectively within various cultural contexts.
Treats others with dignity and respect.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...Produce Quality
Has great overall performance
Effectively organizes resources and plans
Effective in performing his/her job.
Listens and responds to issues and problems
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts easily to incorporate various perspectives.
Recognizes and quickly adapts to shifts in the environment, market, or industry.
Adapts to different settings, tasks, and challenges with ease.
Regularly assesses current methods, welcomes feedback, and is willing to implement changes to improve efficiency and effectiveness.
Implements changes as a result of having listened to employees
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies ways to simplify work processes and reduce cycle times
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Encourages risk taking and experimentation to improve performance
Seeks and utilizes opportunities for continuous learning and self-development.
Completes work on time
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Confronts problems immediately without supervisor instructions.
Acts quickly when an opportunity becomes available.
Initiates important conversation topics at meetings.
Actively works on resolving the issue instead of procrastinating or hoping it will resolve itself.
Immediately informs the HR Department of any personnel complaints or issues.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes all assigned tasks.
Provides clear expectations for employees.
Concentrates efforts on the most urgent needs.
Sets objectives for the department.
Willing to adapt to new procedures to maintain production capacities.
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.
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.
Supports technical training and development of employees.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Responsible for setting the vision of the department.
Completes assigned work tasks.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees to solve problems on their own.
Gives employees the resources they need to complete the job.
Gives employees input into the decision making process.
Expresses confidence in the abilities of others.
Assigns tasks that allow employees to use their critical thinking skills.
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Reinforces and rewards employees for accomplishing necessary goals.
Compliments other people when they do good work
Recognizes team members who offer a significant contribution to a project.
Lets employees know when they have done well
Says "thank you" to show appreciation for work of others.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the use of [Company] products and services.
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
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: