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
You help others when free-time is available.
You demonstrate the personal confidence to "stay the course," even when faced with difficulty
You direct team in prioritizing daily work activities
You explain the "whys" behind organizational objectives
You do not become distracted by non-issues or interruptions.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You effectively organize resources and plans
You set long-term and short-term goals.
You organize and schedules events, activities, and resources.
You work toward achieving established goals and objectives.
You are able to establish realistic goals.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You ask for additional information when making critical decisions.
You break complex issues into manageable parts and organize them in a systematic way before making decisions
You are able to make decisions quickly.
You assess the risks, benefits, and potential impact of a number of options when deciding a course of action
You coach team members individually when "poor" decisions are made and helps them see what could have been done differently
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You encourage open communication to ensure that all proposals are considered.
You challenge current procedures to develop other alternatives.
You create a safe environment for idea-sharing.
You suggest new ideas at meetings.
You analyze current procedures and identify opportunities for improvement.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You work effectively in dynamic and changing work environments.
You learn from personal experiences and/or mistakes.
You are proactive and takes steps to prepare for changes in the workplace.
You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
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 analyze processes to determine areas for improvement.
You are open to the suggestions from others.
You look for ways to improve work processes and procedures.
You look for ways to expand and learn new job skills.
Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You set an example for others to follow
You keep staff informed about what is happening in the company
You take responsibility for things that go wrong
You delegate tasks effectively
You make others feel enthusiastic about your work
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You have strong technical/computer skills.
You complete reports on-time.
You have strong organizational skills to keep the workspace and department in order
You are able to develop, justify and present a budget.
You are enthusiastic about taking on challenging projects.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You conduct timely follow-up; keeps others informed on a need to know basis.
You establish and document goals and objectives.
You set challenging stretch goals
You set high expectations and goals; encourages others to support the organization.
You make sure that team members have a clear idea of our group's goals.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You set high personal standards of performance.
You set a good example.
You act as a resource without removing individual responsibility.
You are responsible for setting the vision of the department.
You complete assigned work tasks.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to say "no" when it is essential to maintaining quality and high standards.
You are flexible in responses.
You establish clear communications to avoid misunderstandings.
You maintain communication channels between parties in the negotiation.
You are able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.

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: