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.
Completes assigned work tasks.
Behavior is ethical and honest.
Holds herself / himself accountable to goals / objectives
Acts as a resource without removing individual responsibility.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is committed to enhancing their own knowledge and skills.
Takes initiative for own learning and development.
Stays up-to-date on emerging technologies.
Will participate in training classes even if offered outside of normal working hours.
Is open to feedback from others.
Punctuality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Starts meetings on time.
Starts the workday when scheduled.
Conducts appointments at scheduled start time.
Maintains an efficient schedule of activities.
Invoices clients on a timely basis.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to express themselves clearly.
Is attentive to emotional cues and interprets others' feelings correctly.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acquires and allocates internal and external resources needed for the project.
Regularly reviews project performance and goals.
Regularly measures and records progress of the project.
Monitors timelines and milestones to ensure set benchmarks are met.
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
Understands & contributes to development of strategic goals.
Achieves established goals.
Achieves goals.
Makes sure that team members have a clear idea of our group's goals.
Sets high expectations and goals; encourages others to support the organization.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains positive customer relationships.
Interacts with customers to define roles, expectations, and responsibilities.
Competent in managing customer projects.
Focuses on maintaining good relationships with customers.
Is committed to the success of the customer.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains infrastructure to support partnerships and networks.
Supports a partnering/networking culture.
Partners with peers to obtain influence within the Company.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Capitalizes on partnerships and networks to enhance the Company's bottom line.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Clearly expresses expectations to others.
Tries to understand others' point of view before making judgments
Deals effectively with employee grievances.
Helps employees to think through alternative ways to resolve conflict situations.
Discusses conflict situations with supervisor.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Lets employees know how their roles contribute toward the achievement of strategic company objectives.
Implements long-term solutions to problems.
Develops a plan and strategy for each functional area within the mission statement.
Creates values statement to ensure all employees are working under the same guiding principles.
Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.

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: