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
Completes assigned work tasks.
Behavior is ethical and honest.
Works in a way that makes others want to work with her/him.
Acts as a resource without removing individual responsibility.
Sets a good example
Passion To Learn	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates a willingness to participate in continuing education courses.
Embraces new technology and procedures.
Demonstrates through personal behavior the commitment to high standards of performance.
Stays up-to-date on emerging technologies.
Enhances value to the company through additional training and development.
Punctuality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conducts appointments at scheduled start time.
Starts the workday when scheduled.
Avoids making personal phone calls during working hours.
Responds to requests for information in a timely manner.
Maintains an efficient schedule of activities.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to control their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Able to understand others' points of view.
Is able to manage their own emotions.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Conducts a risk assessment for each phase of the project.
Establishes the scope for the project.
Estimates the staffing requirements for the project.
Correctly estimates the cost of supplies for the project.
Holds meetings with supply-chain vendors regarding acquisition of resources.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands & contributes to development of strategic goals.
Achieves established goals.
Goal Setting
Establishes and documents goals and objectives.
Achieves goals.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Makes sure their interests are aligned with the customer's interests.
Documents customer interactions.
Maintains strong relationships with customers.
Is committed to the success of the customer.
Is available to respond to customer needs.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains infrastructure to support partnerships and networks.
Identifies the right alliance partners with complementary and compatible services and resources.
Organizing team-building activities to strengthen bonds between colleagues.
Understands the potential risks/rewards of the partnership.
Builds alliances between departments and teams.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Promotes employee engagement to reduce tensions and negativity, creating an environment where conflicts are easily managed.
Explores the feasibility of alternative solutions to resolve conflicts.
Prepares team members to accept differing view points.
Actively engages both parties to voluntarily collaborate and resolve their differences.
Helps to maintain dignity of all persons involved.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Formulates policies and strategies for addressing the Company's important challenges.
Meets with customers to gain insight into their core needs and how best to serve them.
Converses with customers and clients to get a better insight into their personal needs.
Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
Identifies root causes of 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: