Passion to Learn - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

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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Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You inspire others to learn new things.
You take initiative for own learning and development.
You are committed to enhancing your own knowledge and skills.
You are open minded and curious about learning new skills.
You will participate in training classes even if offered outside of normal working hours.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You acknowledge your own biases in cultural interactions.
I seek clarification to avoid misunderstandings.
I seek knowledge and information about other cultures.
I participate in cultural training sessions/classes.
I seek to reduce obstacles in communication that might arise from cultural differences.
Bias for Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You identify ways to simplify work processes and reduce cycle times
You complete a large volume of work.
You motivate others to achieve or exceed goals
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You convey a sense of urgency about addressing problems and opportunities
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You shown significant improvement in job performance.
You listen and respond to issues and problems
You are able to organize work.
You effectively organize resources and plans
You set a high standard for job performance.
Flexibility	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I adapt strategies to fit the specific needs of each situation.
You are dedicated to evolving and enhancing business processes, which demonstrates flexibility.
I introduce new products or services.
I am willing to change ideas or perceptions based on new information.
I am flexible in effectively handling changes in production volumes.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are flexible when dealing with changes.
You respond quickly to new information.
You are able to step in and help co-workers when needed.
You handle changes easily.
You can adjust tactics and strategies.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are effective in solving problems.
You understand the root causes of problems.
You are a good problem solver and decision maker
You actively seek the root cause of a problem.
You can develop innovative solutions to problems.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I take on additional tasks without being asked or told to do so.
You seize upon opportunities available.
You immediately work to complete goals well before your deadline.
You help the department take the initiative to create new solutions.
You seek and utilize opportunities for continuous learning and self-development.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You determine the parts of the project that need completed first.
You set a common goals for the team.
You are a high achiever.
You direct team in prioritizing daily work activities
I prioritize tasks to best achieve the results.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You commit adequate resources toward safety measures.
You are not afraid to question a potential safety issue observed in the workplace.
You participate in safety training when available.
You ensure compliance with safety regulations.
You develop a strong safety culture.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You set a good example
You set high personal standards of performance.
You set a good example.
You take personal responsibility for results.
You complete assigned work tasks.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You develop the skills and capabilities of others.
You meet regularly with employees to coach them on areas that will enhance your performance
You provide clear, motivating, and constructive feedback.
You help employees to maintain high personal standards.
You conduct regular performance appraisals and feedback.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You build alliances between departments and teams.
You maintain infrastructure to support partnerships and networks.
You develop partnerships with senior leaders in the company.
You engage in collaborative problem-solving to address shared challenges.
You supports strategic alliances to combine strengths of both parties.

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

    -Excellent -Good -Average -Poor




67. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
68. 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?
    
    
    
69. What changes do you see [Company] making in order to raise the standards?
    
    
    
70. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
71. What do you like best about working for [Company]?
    
    
    
72. 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: