Responsibility - 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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Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Responsible for setting the vision of the department.
Behavior is ethical and honest.
Works in a way that makes others want to work with her/him.
Completes assigned work tasks.
Sets a good example
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Stays up-to-date on emerging technologies.
Creates an environment that supports personal development and exploration.
Enjoys learning new skills and techniques.
Enhances value to the company through additional training and development.
Demonstrates through personal behavior the commitment to high standards of performance.
Punctuality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Arrives to meetings on time.
Starts the workday when scheduled.
Starts meetings on time.
Invoices clients on a timely basis.
Maintains an efficient schedule of activities.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accurately perceives the emotional reactions of others.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to control their own emotions.
Is able to manage their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Determines the project scope.
Determines the correct order for the phases of the project.
Creates the communications that will be used throughout the project's implementation.
Identifies potential risks that could pose challenges to the project timeline.
Schedules project phases and tasks to facilitate successful completion of the project.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of the objectives and intentions that assigned goals aim to achieve.
Successfully meets deadlines for achieving goals.
Communicates to staff the importance of each goal letting them know of the priorities.
Clearly conveys to staff the significance of each goal, emphasizing their priorities.
Offers useful critiques and assistance to colleagues to achieve their objectives.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures customers are comfortable with the services provided.
Creates documents that meet the customer's specifications.
Focuses on maintaining good relationships with customers.
Makes sure customer needs are understood by the team members.
Ensures every customer receives the same high standard of service, regardless of the situation.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Aligns efforts, processes, and resources with partners to maximize strategic opportunities.
Creates a shared knowledge base or resource center accessible to all partners.
Manages effective partnerships between public, private, and non-profit sectors.
Leverages core competencies of partners to the benefit of both parties.
Develops internal alliances with others in the department.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies areas of agreement and common ground.
Encourages individuals to modify their underlying work behaviors that may have contributed to the conflict.
Clarifies decision-making protocols during conflict to ensure accountability and avoid power struggles.
Signals respect and attentiveness, even when tensions are high or perspectives diverge sharply.
Ensures that both parties work toward finding compromise.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Pursues strategic alliances with valued partners.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Lets employees know how their roles contribute toward the achievement of strategic company objectives.
Demonstrates knowledge of organizational history, values, and long-term goals when making strategic recommendations.
Recognizes when strategic plans are no longer relevant due to environmental or organizational changes.

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

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
53. 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?
    
    
    
54. What changes do you see [Company] making in order to raise the standards?
    
    
    
55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
56. What do you like best about working for [Company]?
    
    
    
57. 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: