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 confidently communicate across all organizational levels, including external stakeholders.
You present issues, ideas, and strategy concisely and clearly.
I am able to communicate ideas effectively and succinctly to both individuals and groups, in any setting.
I am approachable, dependable, and ready to assist when needed.
I mark my status as "available" to signal I am open for communication.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to adjust plans to meet new situations.
You are open to new ideas and innovations.
You are able to quickly learn new ways of performing your job.
You can adjust priorities to the new Corporate mission.
You will stop what you are doing to help colleagues in need.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are curious and willing to ask questions about the cultural differences in the workplace.
I view diversity as a strength, not as an issue.
I help other employees to become more culturally sensitive.
You seek out different viewpoints and benefits from different perspectives.
You support and mentor others that may have different cultural backgrounds.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are a highly effective supervisor.
You motivate others to reach and exceed organizational goals and objectives.
You are able to align manpower, design work, an allocate tasks to achieve goals.
You are able to influence others.
You sit down regularly with employees to review your job performance.
Delegation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You allow employees to decide how they wish to complete the tasks.
You assign tasks to create learning opportunities for the employees.
You define goals and objectives for subordinates.
You clearly define duties and tasks to be completed.
You encourage and empower subordinates to use initiative in achieving goals and objectives.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You analyze current procedures and identify opportunities for improvement.
You encourage open communication to ensure that all proposals are considered.
You foster a creative and innovative work environment.
You take risks to advance important ideas.
You develop new products and services.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I quickly analyze the situation to determine the most pressing needs.
You achieve high levels of performance.
I set benchmarks and milestones to measure progress toward the objectives.
You work toward achievement of goals even when confronted with obstacles.
I remove bureaucratic barriers to streamline processes.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You commit adequate resources toward safety measures.
You support safety programs and procedures.
You mitigate hazards and safety issues that arise.
You develop a strong safety culture.
You encourage others to attend safety training.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are responsible for setting the vision of the department.
You set a good example
Your behavior is ethical and honest.
You take personal responsibility for results.
You set a good example.
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You keep track of changes in legislation affecting regulatory compliance.
You provide documents and reports as needed to maintain compliance with laws.
You offer training to employees to ensure they comply with regulations.
You know who to contact at various regulatory agencies if needed.
You understand the applicable regulations and laws that impact our business.

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: