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.

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Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...Overall Performance
Shown significant improvement in job performance.
Has great overall performance
Effective in performing his/her job.
Works well in this position.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes data and information from several sources and arrives at logical conclusions.
Analyzes issues and reduces them to their component parts.
Balances risks and costs with the rewards and probabilities of success when decisions.
Prioritizes various actions to be taken when solving a problem.
Implements data validation techniques and methods.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Goes above and beyond the stated goals.
Will continue to work on a problem even in the face of obstacles.
Cleans the workspace without being told.
Guides strategic initiatives to advance the department/organization.
Engages with new customers immediately.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Not afraid to think outside the box when dealing with issues.
Helps to identify and create value from innovation.
Uses innovation to solve urgent specific problems.
Modifies innovative initiatives to capitalize on strengths and mitigate potential risks.
Establishes systems of continuous improvement.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adjusts plans to meet the needs of new constraints.
Responds quickly to new information.
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Is open to change and adjusts plans when needed.
Adjusts strategy when new information is presented.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coordinates all department activities into a cohesive team effort.
Able to focus on a task even when working alone.
Takes immediate action toward goals.
Committed to the team.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is not afraid to question a potential safety issue observed in the workplace.
Commits adequate resources toward safety measures.
Encourages others to work safely.
Supports our company's safety programs.
Participates in safety training when offered.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Engages in partnerships to share risks and resources.
Organizing team-building activities to strengthen bonds between colleagues.
Facilitates communication with others in the company.
Promotes a culture of open collaboration, offering ample opportunities and incentives for knowledge sharing and mutual learning.
Contacts possible partners to seek new opportunities.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is prepared to walk away if core interests are not met.
Ensures a thorough understanding of key issues and priorities.
Sets and maintains firm negotiating limits and boundaries.
Leverages relationships with others to achieve goals.
Understands the other person's needs, concerns, and motivations.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Constructively receives criticism and suggestions from others.
Is able to see issues from others' perspectives.
Treats others with respect and dignity.
Includes others in the decision making processes.
Respects the opinions of other employees.
Global Perspective	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has positive interactions with individuals from different cultures and backgrounds.
Engages in problem solving with individuals outside of the country.
Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.
Able to listen and understand others and discuss issues in a respectful way.
Is able to work with individuals having different backgrounds and cultures.

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: