Juggling Multiple Responsibilities - 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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Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coordinates the work of a team by assigning tasks to other team members.
Spends the most time and effort on critical tasks first.
Organizes tasks for the most efficient order of completion.
Keeps track of multiple assignments and deadlines.
Prioritizes tasks for efficiency.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Performs a cost/benefit analysis before making a decision.
Does not lose sight of the big picture when making decisions
Makes creative decisions.
Effectively chooses appropriate courses of action.
Determines constraints that may impact what decisions are acceptable.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Quickly comes to the aid of those who may need help.
Begins immediate action on projects.
Engages with new customers immediately.
Immediately works on solving problems.
Acts with urgency when time is of the essence.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Asks the "right" questions to size up or evaluate situations.
Uses appropriate techniques to solve problems.
Analyzes data and information from several sources and arrives at logical conclusions.
Selects the appropriate techniques for analysis.
Balances risks and costs with the rewards and probabilities of success when decisions.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters a high standard of ethics and integrity.
Accepts responsibility for mistakes.
Demonstrates sincerity in actions with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Demonstrates honesty and truthfulness at all times.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Enhances value to the company through additional training and development.
Creates an environment that supports personal development and exploration.
Stays up-to-date on emerging technologies.
Is committed to enhancing their own knowledge and skills.
Is open to feedback from others.
Attitude	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works to eliminate unnecessary work or barriers that get in others' way.
Visibly supports and encourages diversity in style and background.
Shows by their actions that they trust in the positive intentions of others.
Contributes to a positive and fun work environment.
Is gracious and professional in their interactions with others.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides direction and coaching to employees.
Enhances teamwork through good supervision.
Has a strong work ethic that inspires others.
Communicates effectively with employees.
Provides detailed feedback to employees.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Interacts with customers to define roles, expectations, and responsibilities.
Responds to feedback from customers.
Creates high quality products for the customers.
Manages customer accounts with high degree of competence.
Adapts to changes proposed by the customer.
Company	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Expresses loyalty and dedication to [Company] in interactions with others.
Impresses upon others the important aspects of [Company].
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.

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

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


53. 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?
    
    
    


54. What changes do you see [Company] making in order to raise the standards?
    
    


55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


56. What do you like best about working for [Company]?
    
    


57. 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: