Teamwork- 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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Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Relates to all kinds of people tactfully
Act as an effective team player
Provides assistance and support to other team members when needed
Encourages open communication
Creates opportunities to learn with other team members
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates leadership and courage in critical situations.
Acts decisively in implementing decisions.
Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
Able to influence others.
Highly effective supervisor.
Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accepts the views of others.
Is easy to approach with ideas and opinions.
Considers other's opinion and suggestions.
Is visible and approachable.
Open to the suggestions of others.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes action without being asked.
Prepares for unexpected contingencies.
Takes the initiative to change the direction or course of events.
Seeks and utilizes opportunities for continuous learning and self-development.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Can multi-task while performing all of their other responsibilities and activities.
Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
Plans and organizes continuously while performing all other responsibilities and activities.
Bounces back from daily crisis, disappointments and frustrations.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to attend safety training.
Identifies and addresses safety needs.
Performs work safely.
Participates in safety training as applicable.
Works to implement corrective safety measures.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts coaching and mentoring approach to meet the style or needs of individuals
Takes immediate action on poor performance
Works to identify root causes of performance problems
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Organizational Fluency	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to deal with sensitive issues with tact and professionalism.
Able to use corporate politics to advance department objectives.
Anticipates problems that may affect the department.
Understands departmental policies and procedures.
Understands the current organizational culture.

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

    -Excellent -Good -Average -Poor




42. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    


43. 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?
    
    
    


44. What changes do you see [Company] making in order to raise the standards?
    
    


45. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    


46. What do you like best about working for [Company]?
    
    


47. 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: