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
Focuses on understanding the other team member's message.
Helps the team balance analysis with decisiveness in making decisions.
Works with other team members on the project.
Relates to all kinds of people tactfully
Considers the impact and implications of decisions on the team.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Guides decision-making by coaching, counseling and rewarding.
Recognizes individual and team accomplishments and reward them appropriately.
Gives direct, constructive, and actionable feedback.
Able to influence others.
Motivates others to reach and exceed organizational goals and objectives.
Feedback	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Considers other's opinion and suggestions.
Is visible and approachable.
Seeks feedback to enhance performance.
Actively seeks feedback from others.
Shares past experiences with others as learning opportunities.
Initiative	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes action to establish clear and concise deadlines for tasks to be completed.
Gladly seeks additional responsibilities.
Takes on additional tasks without being asked or told to do so.
Addresses small problems before they become big ones.
Is an inspiration for others to perform above expectations.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Determines which tasks are critical and which tasks are optional.
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Ensures that assignments are prioritized according to the needs of the department/company.
Prioritizes tasks for efficiency.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps accurate safety records.
Committed to safety in the workplace.
Participates in safety training as applicable.
Is not afraid to question a potential safety issue observed in the workplace.
Supports our company's safety programs.
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
Works to identify root causes of performance problems
Adapts coaching and mentoring approach to meet the style or needs of individuals
Sets and clearly communicates expectations, performance goals, and measurements to others
Takes immediate action on poor performance
Organizational Fluency	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to use corporate politics to advance department objectives.
Able to explain departmental policies and procedures to others.
Gets things done through the department.
Understands the current organizational culture.
Effective in communicating with others within the organization.

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: