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 complete work on time.
I determine the objectives for the project.
You demonstrate the personal confidence to "stay the course," even when faced with difficulty
You identify the steps needed to accomplish the results.
I work hard despite obstacles that impede progress.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You set long-term and short-term goals.
You encourage others to take on greater responsibility.
You consistently provide me with timely feedback for improving my performance.
You organize and schedules events, activities, and resources.
You communicate goals and objectives to employees.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You remain focused on the immediate goal when making decisions.
I evaluate information before making a final decision.
I am open to listening to others who may have different ideas.
You apply creative reasoning in making decisions.
You understand factors are important for deciding if a decision is "worth it"?
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I guide the department's innovation focus.
I prioritize technical skill development among employees to foster a culture of innovation and creativity.
You take risks to reach beyond boundaries.
You guarantee that team members are equipped with the technical expertise needed to excel in innovative projects.
You suggest new ideas at meetings.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to quickly learn new ways of performing your job.
You are flexible when dealing with changes.
You are able to adjusts tactics when things are not working as expected.
You are able to adapt to changes in technology and processes.
You are able to work effectively with new people and new teams.
Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You look for ways to expand current job responsibilities.
You analyze processes to determine areas for improvement.
You are open to the suggestions from others.
You look for ways to expand and learn new job skills.
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 set an example for others to follow
You keep staff informed about what is happening in the company
You delegate tasks effectively
You make others feel enthusiastic about your work
You take responsibility for things that go wrong
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You accurately implement contract provisions.
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.
You implement and use performance measures.
Goals	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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 make sure that team members have a clear idea of our group's goals.
You set challenging stretch goals
You establish and document goals and objectives.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You take personal responsibility for results.
You set a good example.
You complete assigned work tasks.
You act as a resource without removing individual responsibility.
You set a good example
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You understand the motivations of the other party.
You are flexible in responses.
I develop a unified understanding or strategy that acknowledges and addresses the different viewpoints and resolves conflicts.
You find shared interests and solutions that benefit all parties involved.
You are prepared to walk away if core interests are not met.

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: