Performance - 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.

---

Edit this Survey

Would you like to edit this survey? Click here to begin.

Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Gradually increases the complexity of assignments as employees demonstrate readiness.
Sets and achieves ambitious goals; makes change happen.
Works well in this position.
Takes responsibility for making tough decisions.
Prevents setbacks from derailing progress by quickly establishing a new path forward.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Presents quantitative data in a clear and concise manner aiding in making persuasive and evidence-based arguments.
Figures out where issues might arise.
Easily able to separate a process/procedure into its component parts.
Actively seeks constructive feedback from others.
Presents data in a format that makes comparisons easier.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Actively works on resolving the issue instead of procrastinating or hoping it will resolve itself.
Confronts problems immediately without supervisor instructions.
Maintains momentum on long-term initiatives despite shifting priorities or limited support.
Anticipates, prepares, and acts proactively to address issues in the department.
Actively works on problems instead of just thinking about them.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in bringing up new ideas.
Promotes collaboration across different departments to combine varied perspectives and expertise, which can spark innovative ideas.
Prioritizes technical skill development among employees to foster a culture of innovation and creativity.
Empowers employees to create innovative solutions to problems.
Participates in cross-functional innovation teams.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in working with different personnel of the team.
Responsive to the needs of others.
Adapts to changes in team membership.
Learns new skills to stay competitive in the workplace.
Easily accepts new responsibilities.
Commitment	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Engaged in decision-making, inspiring commitment to the process of achieving goals.
Persistent and dedicated to obtaining results.
Links individual contributions to collective success, instilling accountability and urgency for outcomes.
Strengthens employee dedication to applying their skills in service of organizational goals.
Maintains discipline in execution, ensuring commitment to rigor and consistency in work.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes teams or individuals who contribute to hazard reduction.
Conducts follow up safety inspections after critical incidents.
Consistently incorporates proven safety methods and standards into daily operations and program planning.
Identifies areas that may be impacted by a disaster.
Ensures employees are certified according to Federal regulations/standards.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops partnerships with other colleagues in the industry.
Identifies areas in the partnership that require corrective action.
Is comfortable working in partnership with colleagues from other departments.
Negotiates clear terms of collaboration that define roles, responsibilities, deliverables, and performance expectations for all partners involved.
Supports communication and collaboration with other leaders in the industry.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains consistency in applying boundaries even when under pressure, ensuring fairness and predictability in the negotiation process.
Detects inconsistencies between what is said and how it is said, prompting gentle inquiry to uncover hidden constraints or unspoken interests.
Able to control their emotional responses and correctly gauge the emotions of others.
Sets and maintains firm negotiating limits and boundaries.
Keeps emotions in check to avoid negative outbursts.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports the efforts of other employees in implementing solutions to problems.
Is able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Respects the opinions of other employees.
Includes others in the decision making processes.
Global Perspective	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures vendors can meet both current and future business needs.
Implements changes as a result of having learned from experiences in overseas assignments.
Analyzes cost structures, talent availability, operational risks, and long-term organizational capability to determine onshoring/offshoring of business functions.
Identifies where collaboration with other organizations can create mutual advantage.
Shares global market insights, regulatory updates, and cultural considerations with domestic teams to ensure decisions are informed by international realities.

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: