Communication - 360 Degree Feedback Survey Sample #4

Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

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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Communication Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I communicate crucial information to others.
I confidently interact with all tiers of the organization.
I provide straightforward and brief directions.
You make the complex simple.
I provide the reasoning behind choices and actions.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You learn from personal experiences and/or mistakes.
You adjust strategy when new information is presented.
You are able to adjust plans to meet new situations.
You are open to new ideas and innovations.
You are aware of changes to the policies and procedures.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You treat others with dignity and respect.
You respect others regardless of age, race, gender, nationality, or disability.
You communicate with others without the influence of racism.
I actively listen to other employees' stories about their culture.
You are open to learning about different cultures.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to organize the work of others.
You are able to influence others.
You motivate others to reach and exceed organizational goals and objectives.
You set clear goals and objectives for subordinates.
You are a highly effective supervisor.
Delegation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You clearly define duties and tasks to be completed.
You assign tasks to create learning opportunities for the employees.
You set clear and reasonable expectations for others and follow through on their progress.
You encourage and empower subordinates to use initiative in achieving goals and objectives.
You allow subordinates to use their own methods and procedures.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create new programs and systems.
You use unconventional approaches to solve problems.
You champion changes within the organization.
You facilitate acceptance of new ideas.
I cultivate a culture of open communication where all ideas, no matter how unconventional, are welcomed and valued.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I help the team maintain focus on the goals.
I determine what resources will be needed to achieve the objectives.
You stay focused on solving problems and getting work done.
I am flexible and willing to change the strategy to better achieve the objectives.
I determine the proper order for completion of the tasks.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You develop safety guidelines for the department.
You point out behaviors in others that may be unsafe.
You ensure compliance with safety regulations.
You ensure that all supervisors are aware of regulatory and compliance measures.
You keep accurate safety records.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are a person others can trust.
You complete assigned work tasks.
You act as a resource without removing individual responsibility.
Your behavior is ethical and honest.
You work in a way that makes others want to work with you.
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I create necessary compliance policies and procedures.
I provides direction and oversight for the compliance department.
You explain regulations and procedures to others as required.
I create and implement training courses for new hires to ensure knowledge of regulations and policies.
You create a standardized response protocol for responding to compliance related issues.

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: