Results Oriented - 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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Results Oriented	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I work hard despite obstacles that impede progress.
You inspire and motivates co-workers to be productive and energetic at work
I determine what resources will be needed to achieve the objectives.
You direct team in prioritizing daily work activities
You hold yourself and others accountable for achieving results.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You encourage others to take on greater responsibility.
You are able to establish realistic goals.
You assure [Company] principles are understood, employed & pursued.
You work toward achieving established goals and objectives.
You are able to organize work.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You use reasonable assumptions and logic to decide between alternate courses of action
I define what constraints must be met for the decision making process.
You break complex issues into manageable parts and organize them in a systematic way before making decisions
You determine the costs and potential benefits of decisions.
I make decisions that support the department's goals and objectives.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You suggest new ideas at meetings.
You offer constructive improvements to existing systems.
You challenge current procedures to develop other alternatives.
You encourage open communication to ensure that all proposals are considered.
You solve problems with insight and understanding.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You adjust strategy when new information is presented.
You are able to adjust to new plans and procedures.
You are able to adjust to changes as needed.
You adjust plans to meet the needs of new constraints.
You handle changes easily.
Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You promote training and development opportunities to enhance job performance.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You analyze processes to determine areas for improvement.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
You look for ways to improve work processes and procedures.
Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You delegate tasks effectively
You set an example for others to follow
You keep staff informed about what is happening in the company
You are ready to offer help
You take responsibility for things that go wrong
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You have a high attention to detail.
You have strong organizational skills to keep the workspace and department in order
You implement and use performance measures.
You take responsibility for decisions.
You have strong technical/computer skills.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You establish and document goals and objectives.
You set challenging stretch goals
You achieve established goals.
You conduct timely follow-up; keeps others informed on a need to know basis.
You achieve goals.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work in a way that makes others want to work with you.
You set a good example
You act as a resource without removing individual responsibility.
You complete assigned work tasks.
You are responsible for setting the vision of the department.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I stay composed and counter aggressive negotiation tactics by reframing unreasonable proposals or actions.
You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
You combine the valid points from each source to form a comprehensive and balanced perspective.
You take steps to control emotional responses to avoid making rash decisions.
I keep a firm grasp on the issues and priorities.

56. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




57. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
58. 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?
    
    
    
59. What changes do you see [Company] making in order to raise the standards?
    
    
    
60. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
61. What do you like best about working for [Company]?
    
    
    
62. 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: