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
Act as an effective team player
Is open to new ideas that may change own goals for benefit of the team
Shares credit for accomplishments with team members
Actively and openly participates in group meetings.
Carries his/her share of the workload
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates leadership and courage in critical situations.
Motivates and challenges employees to attain a shared vision.
Takes ownership and accountability for results
Recognizes individual and team accomplishments and reward them appropriately.
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.
Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is easy to approach with ideas and opinions.
Open to the suggestions of others.
Accepts the views of others.
Considers other's opinion and suggestions.
Shares past experiences with others as learning opportunities.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks and utilizes opportunities for continuous learning and self-development.
Begins immediate action on projects.
Immediately works on solving problems.
Able to initiate work on projects independently without direct supervision.
Looks to start work on new projects without waiting for direction from the manager.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coordinates the work of a team by assigning tasks to other team members.
Completes multiple tasks simultaneously.
Ensures that assignments are prioritized according to the needs of the department/company.
Uses a scheduler/planner to keep tasks organized and on time.
Is aware of the deadlines for specific tasks/assignments.
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.
Identifies and addresses safety needs.
Points out behaviors in others that may be unsafe.
Develops a culture of safety.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Gives others development opportunities through project assignments and increased job responsibilities
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
Organizational Fluency	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Gets things done through the department.
Able to explain departmental policies and procedures to others.
Adept at navigating within the culture of the department.
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: