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
You address issues of key importance to stakeholders.
You make the complex simple.
You deliver influential presentations.
You communicate goals of project, resources required, resources available, etc. to the team
You are persuasive and articulate when communicating.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are proactive and takes steps to prepare for changes in the workplace.
You are able to adjust plans to meet new situations.
You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
You work effectively with various personalities of team members.
You adjust plans to meet the needs of new constraints.
Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You seek out different viewpoints and benefits from different perspectives.
I help other employees to become more culturally sensitive.
I am aware of cultural differences in business etiquette.
You maintain an inclusive work environment that maximizes the talents of others in achieving goals.
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 demonstrate leadership and courage in critical situations.
You are a highly effective supervisor.
You are able to organize the work of others.
You are able to influence others.
You express clear goals and objectives.
Delegation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You entrust subordinates with important tasks.
You tell subordinates what to do, not how to do it.
You delegate authority and responsibility to subordinates and holds them accountable for your actions.
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
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 value diverse opinions among team members.
I keep an open mind towards innovative concepts ensuring managers are continuously exploring potential growth avenues.
You create new products or services.
You promote disruptive innovation empowering managers to challenge the status quo and push the boundaries of what's possible.
You create new and efficient processes.
Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are willing to take on new assignments to help increase production.
I remove bureaucratic barriers to streamline processes.
You are determined to complete tasks regardless of obstacles that may occur.
You set important goals for the department.
You are considered a high achiever.
Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are not afraid to question a potential safety issue observed in the workplace.
You point out behaviors in others that may be unsafe.
You create accurate and effective measures of safety.
You work to implement corrective safety measures.
You encourage others to work safely.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You complete assigned work tasks.
You set a good example
You set a good example.
You are a person others can trust.
You are responsible for setting the vision of the department.
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work quickly to implement changes in regulations.
You create and maintain necessary regulatory documentation.
I establish clear communication channels and lines of communication for compliance related issues.
I ensure the company is in compliance with industry specifications, standards, and applicable laws.
You maintain a state of readiness to address new and changing regulations and procedures.

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: