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
Able to organize work.
Effectively organizes resources and plans
...Overall Performance
Effective in performing his/her job.
Has great overall performance
Analytical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies the root cause of a problem.
Asks the "right" questions to size up or evaluate situations.
Prioritizes various actions to be taken when solving a problem.
Uses appropriate techniques to solve problems.
Balances risks and costs with the rewards and probabilities of success when decisions.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts quickly when an opportunity becomes available.
Informs the manager of any important changes in the equipment operation.
Immediately informs the supervisor of any critical incidents.
Confronts problems immediately without supervisor instructions.
Is proactive and gets things done.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Solves problems with insight and understanding.
Takes risks to advance important ideas.
Suggests new ideas at meetings.
Finds creative ways to get things done with limited resources.
Creates improved methods or solutions for meeting goals and objectives.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is flexible when dealing with changes.
Able to respond to incidents without stopping the workflow.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Able to adapt to changes in technology and processes.
Adjusts to new plans and procedures.
Commitment To Result	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains persistence and dedication to achieving results.
Encourages commitment in others to obtain results.
Able to focus on a task even when working alone.
Coordinates all department activities into a cohesive team effort.
Committed to the team.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops safety guidelines for the department.
Participates in safety training when available.
Participates in safety training as applicable.
Ensures that all supervisors are aware of regulatory and compliance measures.
Develops a sustainable safety culture.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Invests in other companies to form equity partnerships.
Implements effective oversight of network activities.
Promotes teamwork across departments, encouraging information exchange, and setting common goals.
Identifies partnerships with overseas companies to expand market opportunities.
Ensures that lessons learned from the partnership are disseminated and built upon.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates confidence in own position and can influence the other party's perception of proposals being offered.
Takes steps to control emotional responses to avoid making rash decisions.
Fully grasps both party's interests and options.
Finds shared interests and solutions that benefit all parties involved.
Listens to all sides without bias and makes fair decisions.
Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Constructively receives criticism and suggestions from others.
Helpful
Able to see issues from others' perspectives.
Is able to see issues from others' perspectives.
Works effectively with people from other departments.
Global Perspective	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Understands how cultures differ and how these differences impact work behavior.
Can effectively deliver presentations to international clients.
Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
Is aware of the culture, behaviors, identities and beliefs of others.

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: