Problem Solving - 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.

---

Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in solving problems.
Is a good problem solver and decision maker
Solves problems using logic and insight.
Ability to solve problems at root cause rather than at symptom level.
Works cooperatively with others to solve problems.
Change Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in implementing new organizational vision and values.
Works cooperatively with others to implement changes.
Adopts changes to set and example for others to follow.
Supports new initiatives for organizational changes to improve effectiveness.
Assists others in understanding changes to the organization.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops insights and applies innovative solutions to projects and problems.
Is proactive and takes steps to prepare for changes in the workplace.
Works effectively in dynamic and changing work environments.
Able to work effectively with new people and new teams.
Flexible and open to new ideas and encourages others to value change.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is attentive to emotional cues and interprets others' feelings correctly.
Is able to manage their own emotions.
Is able to express themselves clearly.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Treats all staff equitably.
Is aware of the unique strengths of each employee.
Encourages employees to achieve their full potential.
Maintains good working relationships with employees.
Appropriately recognizes and rewards employees.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works in an organized manner
Able to identify the needs of the department before a major change.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Anticipates obstacles and ways to overcome them.
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.
Implements data validation techniques and methods.
Identifies problems and issues needing resolution.
Prioritizes various actions to be taken when solving a problem.
Balances risks and costs with the rewards and probabilities of success when decisions.
Technical	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willingly shares information and expertise; sought out as resource by others
Seeks information from others as needed.
Willingly shares his/her technical expertise; sought out as resource by others
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Builds alliances between departments and teams.
Seeks an understanding of diverse functions within the Company.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Collaborates with others to accomplish goals and objectives.

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

    -Excellent -Good -Average -Poor




47. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


48. 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?
    
    
    


49. What changes do you see [Company] making in order to raise the standards?
    
    


50. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


51. What do you like best about working for [Company]?
    
    


52. 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: