Quality - 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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Quality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Engages and leads staff in implementation of new quality procedures.
Develops processes to enhance quality standards.
Creates effective policies regarding quality of services and products.
Competently and accurately analyzes quality measures.
Makes sure cleanliness standards are met to reduce the possibility of contamination.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Establishes and documents goals and objectives.
Achieves goals.
Goal Setting
Conducts timely follow-up; keeps others informed on a need to know basis.
Sets high expectations and goals; encourages others to support the organization.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Organizes and schedules events, activities, and resources.
Communicates goals and objectives to employees.
Consistently provides me with timely feedback for improving my performance.
Effectively organizes resources and plans
Encourages me to take on greater responsibility.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adjusts strategy when new information is presented.
Works effectively in dynamic and changing work environments.
Adjusts to new plans and procedures.
Able to adjust to changing environments.
Able to respond to incidents without stopping the workflow.
Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Looks for ways to expand and learn new job skills.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Looks for ways to expand current job responsibilities.
Promotes training and development opportunities to enhance job performance.
Analyzes processes to determine areas for improvement.
Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes responsibility for things that go wrong
Delegate tasks effectively
Is ready to offer help
Sets an example for others to follow
Makes you feel enthusiastic about your work
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Makes sure employees complete the work on time.
Informs employees of what tasks need to be completed on each shift.
Offers instructions and guidance to subordinates.
Works well with the team members.
Provides useful and constructive feedback to employees.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to develop, justify and present a budget.
Completes reports on-time.
Implements and uses performance measures.
Accurately implements contract provisions.
High attention to detail.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts as a resource without removing individual responsibility.
Behavior is ethical and honest.
...takes personal responsibility for results.
Is a person you can trust.
Sets a good example.

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: