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.

---

Edit this Survey

Would you like to edit this survey? Click here to begin.

Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Acts as an effective team player
Works cooperatively with others to solve problems.
Seeks and listens to other's contributions
Works with other team members to identify bottle necks in the production process.
Demonstrates an understanding of other team member's viewpoints.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds others accountable for their actions.
Shares information regarding decision making so that others understand the relevant positions.
Maintains the confidence of others.
Leads team to set goals, solve problems, and accomplish tasks.
Able to increase the performance of under-performing employees.
Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Looks to others for input.
Follows up on any issues identified through the feedback process.
Demonstrates a commitment to personal and professional growth through open acceptance of feedback results.
Considers other's opinions and suggestions.
Conducts effective performance feedback conversations by focusing on helping the employee's career development.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks alternative methods or resources when initial approaches fail or are unavailable.
Inspires others to perform above expectations.
Initiates draft reports for consideration.
Immediately informs the HR Department of any personnel complaints or issues.
Acts quickly when a small problem arises to keep it from becoming a major issue.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assesses current capabilities before committing to new requests from customers.
Ranks the importance of tasks to make sure critical tasks are completed first.
Begins tasks as soon as possible.
Keeps track of multiple assignments and deadlines.
Builds in extra time in the schedule for unplanned events/occurrences.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages others to work safely.
Committed to safety in the workplace.
Participates in safety training as applicable.
Develops a strong safety culture.
Encourages others to attend safety training.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides ongoing feedback to co-workers on their development progress
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
Gives others development opportunities through project assignments and increased job responsibilities
Organizational Fluency	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to explain departmental policies and procedures to others.
Is aware of other organizational cultures to compare/contrast with the current organizational culture.
Understands the current organizational culture.
Anticipates problems that may affect the department.
Understands departmental policies and procedures.

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: