Interpersonal Skills - 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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Interpersonal Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates an atmosphere that supports the open expression of ideas
Is a role model for others demonstrating the importance of interpersonal skills.
Demonstrates positive behaviors for others to follow.
Strives for win/win solutions
Maintains a high degree of honesty and integrity.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willingly accepts the obligation to complete the task.
Consults with the supervisor before engaging in new procedures that have some risk.
Works to achieve established goals.
Accepts personal responsibility for producing high quality and timely work.
Ensures that employee objectives are aligned with the organization's objectives.
Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes action when necessary.
Establishes the tasks and direction for the team.
Starts immediately working on assignments.
Pursues goals with action to achieve success.
Converts plans into actions.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Grasps new ideas, concepts, technical, or business knowledge.
Participates in regular training offered.
Pursues self-improvement through continual learning.
Seeks opportunities to grow in skills and knowledge.
Takes the initiative to learn new skills.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops detailed execution strategies for implementation of the project.
Acquires and allocates internal and external resources needed for the project.
Determines the roles for project team members.
Works with customers and clients to assess their needs and define project parameters.
Has detailed knowledge about the project and can adapt the project plan as needed.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seizes upon opportunities available.
Takes charge when there is a crisis.
Helps the department take the initiative to create new solutions.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Is proactive when preparing for potential problems or critical events.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Streamlines procedures when legacy methods hinder progress.
Makes changes to the plans if it will result in increased output.
Follows up consistently on commitments and deadlines to ensure progress is sustained.
Steps in to cover responsibilities during peak workloads or staff shortages.
Anticipates potential obstacles and builds contingency plans to maintain momentum.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Interacts with customers to define roles, expectations, and responsibilities.
Ensures customers are comfortable with the services provided.
Is aware of the customer's needs.
Has excellent communication with customers.
Thoroughly understands the needs of the customer.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses networks of personal contacts to gain introductions to others who may have valuable information.
Builds trust with colleagues and coworkers.
Is comfortable working in partnership with colleagues from other departments.
Seeks opportunities to meet with others.
Is an active member of professional associations or professional groups to stay connected with peers.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses logic and reasoning to determine the best course of action for resolving the conflict.
Applies diagnostic thinking to interpersonal tensions, identifying whether the issue stems from values, roles, goals, or procedures.
Seeks to maintain positive relationships with coworkers.
Identifies areas of agreement and common ground to form basis of resolution.
Ensures that both parties work toward finding compromise.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes records and reports to obtain insight into potential issues and trends.
Recognizes when strategic plans are no longer relevant due to environmental or organizational changes.
Creates values statement to ensure all employees are working under the same guiding principles.
Identifies root causes of problems.
Pursues strategic alliances with valued partners.

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

    -Excellent -Good -Average -Poor




57. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
58. 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?
    
    
    
59. What changes do you see [Company] making in order to raise the standards?
    
    
    
60. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
61. What do you like best about working for [Company]?
    
    
    
62. 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: