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 explain the "whys" behind organizational objectives
I measure progress toward the goal.
You produce a high volume of work.
You set important goals for the department.
I identify what needs to be accomplished.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to establish realistic goals.
You consistently provide me with timely feedback for improving my performance.
You organize and schedules events, activities, and resources.
You assure [Company] principles are understood, employed & pursued.
You are able to organize work.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You do not lose sight of the big picture when making decisions
I evaluate information before making a final decision.
You decide which long-term goals should be met.
You examine relevant factors needed to make a decision.
I view issues from multiple perspectives before making a decision.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You create a safe environment for idea-sharing.
You find creative ways to get things done with limited resources.
You implement best practices within the department.
You suggest new ideas at meetings.
You build upon the ideas and solutions of others.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are aware of changes to team personnel.
You are able to adjust to new plans and procedures.
You can accommodate changes as needed.
You are flexible and open to new ideas and encourages others to recognize the value of change.
You perform a wide range of tasks, respond to changes in direction and priorities and accept new challenges, responsibilities, and assignments.
Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You analyze processes to determine areas for improvement.
You look for ways to improve work processes and procedures.
You promote training and development opportunities to enhance job performance.
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 take responsibility for things that go wrong
You delegate tasks effectively
You keep staff informed about what is happening in the company
You make others feel enthusiastic about your work
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You implement and use performance measures.
You are able to develop, justify and present a budget.
You are enthusiastic about taking on challenging projects.
You complete reports on-time.
You take responsibility for decisions.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You achieve goals.
You make sure that I have a clear idea of our group's goals.
You conduct timely follow-up; keeps others informed on a need to know basis.
You achieve established goals.
You set high expectations and goals; encourages others to support the organization.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You hold yourself accountable to goals / objectives
You work in a way that makes others want to work with you.
You set a good example
Your behavior is ethical and honest.
You set high personal standards of performance.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You influence others through rational argument and persuasion.
You maintain good interpersonal relationships with representatives from the other party.
You are able to control your emotional responses and correctly gauge the emotions of others.
You stay calm and focus on the core issues to be discussed.
You are flexible in responses.

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: