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
...takes personal responsibility for results.
Acts as a resource without removing individual responsibility.
Responsible for setting the vision of the department.
Holds herself / himself accountable to goals / objectives
Completes assigned work tasks.
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.
Inspires others to learn new things.
Enjoys learning new skills and techniques.
Stays up-to-date on emerging technologies.
Holds self and associates accountable for goal achievement.
Punctuality	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Arrives to meetings on time.
Maintains an efficient schedule of activities.
Invoices clients on a timely basis.
Responds to requests for information in a timely manner.
Conducts appointments at scheduled start time.
Emotional Intelligence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Is able to manage their own emotions.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the financial, strategic, resources, staffing, timeline and market risks that may impact the project.
Creates a schedule for the different phases of the project.
Determines the correct order for the phases of the project.
Hold team members accountable for completing specific tasks on the project.
Develops a plan for resource management.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Achieves goals.
Sets high expectations and goals; encourages others to support the organization.
Conducts timely follow-up; keeps others informed on a need to know basis.
Makes sure that team members have a clear idea of our group's goals.
Understands & contributes to development of strategic goals.
Customer Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Builds long term relationships with customers.
Uses feedback from customers to help improve services.
Anticipates and proactively resolves issues that the customer may face.
Uses feedback from the customer to help improve the customer's experience.
Addresses customer complaints immediately.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Hosts forums, colloquiums, and seminars to share information and ideas.
Provides or participates in joint ventures or co-development projects.
Supports and encourages relationships that are created by diverse team members.
Establishes appropriate monitoring of activities in the network.
Identifies partnerships with overseas companies to expand market opportunities.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to settle disputes equitably.
Helps to maintain dignity of all persons involved.
Attentively hears each person as they share their distinct viewpoints on the matter.
Prevents minor issues from escalating into major problems.
Seeks to reduce the scarcity of limited resources by sourcing materials from new locations.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates with employees to find out their needs.
Develops a plan and strategy for each functional area within the mission statement.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Attends industry conferences to gain further insight into how other companies deal with similar issues.
Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.

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: