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
Develops trust and confidence from others.
Maintains strong relationships with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Fosters an environment built upon trust.
Does what was promised.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of differences in how individuals from other cultures greet one another.
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.
Respects others regardless of age, race, gender, nationality, or disability.
Views diversity as a strength, not as an issue.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works well in this position.
Effective in performing his/her job.
Shown significant improvement in job performance.
Sets a high standard for 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.
Selects strategies according to the demands of the situation.
Adapts easily to incorporate various perspectives.
Acts decisively in frequently changing and uncertain environment.
Adapts to different learning styles of employees as required to make sure employees receive the highest level of training.
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
Conveys a sense of urgency about addressing problems and opportunities
Completes work on time
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Completes a large volume of work.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes corrective action to address performance deficiencies/issues.
Immediately works to complete goals well before their deadline.
Initiates new projects for the department.
Actively works on resolving the issue instead of procrastinating or hoping it will resolve itself.
Does things without being told.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts to disruptions in the supply chain to maintain production levels.
Overcomes obstacles to continue working toward goals.
Achieves performance benchmarks.
Sets objectives for the department.
Provides clear expectations for employees.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maximizes the use of new technology to deliver products and services.
Uses technology in decision making and problem solving.
Adopts the implementation of new technology into the workplace.
Understands and is committed to implementing new technologies.
Applies complex rules and regulations to maintain optimal system performance.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works in a way that makes others want to work with her/him.
Responsible for setting the vision of the department.
Behavior is ethical and honest.
Is a person you can trust.
...takes personal responsibility for results.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Trusts employees with important responsibilities.
Sets goals to allow the employee to have more autonomy over their work.
Permits employees to take training to become more independent.
Encourages independent, original thinking and creative problem-solving.
Enables employees to take on more challenging roles.
Recognition	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Lets employees know when they have done well
Recognizes the abilities and skills of self and others
Compliments other people when they do good work
Is sincerely interested in the suggestions of co-workers
Offers recognition in a timely manner.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Attends [Company] gatherings and social events.
Impresses upon others the important aspects of [Company].

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: