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
Begins tasks as soon as possible.
Prioritizes tasks for efficiency.
Builds in extra time in the schedule for unplanned events/occurrences.
Keeps track of multiple assignments and deadlines.
Organizes tasks for the most efficient order of completion.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Defines parameters that will impact the decision making process.
Examines relevant factors needed to make a decision.
Views the long and short-term impact of decisions.
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Gathers information before making a decision.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes tasks without having to be told to do so.
Takes action to establish clear and concise deadlines for tasks to be completed.
Immediately informs the supervisor of any critical incidents.
Begins immediate action on projects.
Acts quickly when a small problem arises to keep it from becoming a major issue.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Asks the "right" questions to size up or evaluate situations.
Balances risks and costs with the rewards and probabilities of success when decisions.
Selects the appropriate techniques for analysis.
Uses appropriate techniques to solve problems.
Prioritizes various actions to be taken when solving a problem.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains strong relationships with others.
Fosters a high standard of ethics and integrity.
Accepts responsibility for mistakes.
Follows tasks to completion.
Demonstrates sincerity in actions with others.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Enjoys learning new skills and techniques.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Stays up-to-date on emerging technologies.
Creates an environment that supports personal development and exploration.
Is open to feedback from others.
Attitude	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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 work environment.
Works to eliminate unnecessary work or barriers that get in others' way.
Contributes to a positive and fun work environment.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides timely and thorough performance evaluations of employees.
Uses metrics and benchmarks established by the department.
Holds employees accountable for work assignments.
Gives employees the ability to complete their tasks as they see fit.
Leads others through their commitment to the department.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps customers feel they are receiving services tailored specifically to their needs.
Adapts to changes proposed by the customer.
Makes customer's needs a top priority.
Thoroughly understands the needs of the customer.
Focuses on providing excellent customer service.
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 use of [Company] products and services.
Impresses upon others the important aspects of [Company].
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: