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.
Sets high personal standards of performance.
Sets a good example.
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Creates an environment that supports personal development and exploration.
Enhances value to the company through additional training and development.
Will participate in training classes even if offered outside of normal working hours.
Stays up-to-date on emerging technologies.
Punctuality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Arrives to meetings on time.
Starts the workday when scheduled.
Maintains an efficient schedule of activities.
Conducts appointments at scheduled start time.
Starts meetings on time.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to control 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.
Accurately perceives the emotional reactions of others.
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
Organizes, plans, and directs resources to accomplish the goals and objectives.
Works with customers and clients to assess their needs and define project parameters.
Regularly reviews project performance and goals.
Anticipates potential problems and institutes controls and contingency plans to address them.
Defines project outcomes based on customer requirements.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets high expectations and goals; encourages others to support the organization.
Makes sure that I have a clear idea of our group's goals.
Understands & contributes to development of strategic goals.
Makes sure that team members have a clear idea of our group's goals.
Goal Setting
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures customers are comfortable with the services provided.
Meets with customers on a regular basis.
Acts with integrity in all customer interactions.
Creates new and innovative products for customers.
Consistently meets customer's needs.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates value within the Company by building networks.
Seeks an understanding of diverse functions within the Company.
Promotes the understanding of how the department affects the organization overall.
Creates the conditions for partnerships to grow and develop.
Collaborates with others to accomplish goals and objectives.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Deals effectively with employee grievances.
Helps employees to think through alternative ways to resolve conflict situations.
Clearly expresses expectations to others.
Identifies and takes steps to prevent potential confrontations.
Discusses conflict situations with supervisor.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
Maintains knowledge of current trends in the industry.
Analyzes records and reports to obtain insight into potential issues and trends.
Analyzes unique issues or problems impacting the Company.
Implements long-term solutions to problems.

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: