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
Listens and responds to issues and problems
...Produce Quality
Works well in this position.
Effective in performing his/her job.
Shown significant improvement in job performance.
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies problems and issues needing resolution.
Evaluates the integrity and comparability of data and identifies existing gaps.
Identifies potential problem areas.
Evaluates assumptions before taking actions.
Uses logic and reasoning to identify which pieces of information are useful and which are not.
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.
Informs the manager of any important changes in the equipment operation.
Acts quickly when a small problem arises to keep it from becoming a major issue.
Seizes upon opportunities available.
Begins immediate action on projects.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Guides the department's innovation focus.
Sets company-wide innovation performance targets and goals.
Implements best practices within the department.
Encourages others to experiment and learn from their mistakes without fear of retribution.
Maximizes the alternative solutions to problems.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open to changes in policies and procedures.
Continually trying to improve skills to remain current.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Adjusts plans to meet the needs of new constraints.
Is aware of changes to team personnel.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages commitment in others to obtain results.
Maintains persistence and dedication to achieving results.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Takes immediate action toward goals.
Coordinates all department activities into a cohesive team effort.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops a sustainable safety culture.
Ensures that all supervisors are aware of regulatory and compliance measures.
Ensures compliance with safety regulations.
Encourages others to work safely.
Committed to safety in the workplace.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Facilitates inter-departmental collaboration and information sharing.
Encourages employees to explore new partnership opportunities to expand market presence.
Engages in collaborative problem-solving to address shared challenges.
Uses networks of personal contacts to gain introductions to others who may have valuable information.
Engages with partners that offer complementary services and competencies.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Changes communication styles to meet the listener's needs.
Identifies tradeable interests that could facilitate reaching a consensus.
Is aware of potential emotional triggers that could negatively impact the negotiations.
Aims for solutions that benefit both parties.
Adapts strategies to better meet the needs of the moment.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Respects the opinions of other employees.
Works effectively with people from other departments.
Supports the efforts of other employees in implementing solutions to problems.
...treats others with respect and dignity.
Forms working relationships with employees from other departments.
Global Perspective	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Exemplifies the skills of a global worker.
Volunteers for experiences and assignments abroad.
Is aware of the culture, behaviors, identities and beliefs of others.
Works well with others from different cultural backgrounds.
Facilitates open communication with individuals from other countries.

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: