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 are considered a high achiever.
I am always willing to help coworkers to keep productions levels high.
I set objectives for the department.
I determine what resources will be needed to achieve the objectives.
You exceed performance requirements.
Objectives	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You set long-term and short-term goals.
You are able to establish realistic goals.
You are able to organize work.
You assure [Company] principles are understood, employed & pursued.
You organize and schedules events, activities, and resources.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You coach team members individually when "poor" decisions are made and helps them see what could have been done differently
I am open to listening to others who may have different ideas.
You do not lose sight of the big picture when making decisions
You are aware of the impact of decisions and informs others about potential outcomes.
You make decisions based on novel interpretations of the facts.
Innovation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You take risks to reach beyond boundaries.
I cultivate a culture of open communication where all ideas, no matter how unconventional, are welcomed and valued.
You build upon the ideas and solutions of others.
I regularly audit the company's innovation effectiveness.
You offer innovative solutions to Company problems.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
You learn from personal experiences and/or mistakes.
You are able to adjust to changing environments.
You are able to quickly learn new ways of performing your job.
You can handle unexpected events without a loss of productivity.
Continual Improvement	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You look for ways to expand and learn new job skills.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You analyze processes to determine areas for improvement.
You are open to the suggestions from others.
You look for ways to expand current job responsibilities.
Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You make others feel enthusiastic about your work
You keep staff informed about what is happening in the company
You take responsibility for things that go wrong
You delegate tasks effectively
You are ready to offer help
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You have strong technical/computer skills.
You are able to develop, justify and present a budget.
You implement and use performance measures.
You take responsibility for decisions.
You have a high attention to detail.
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 set challenging stretch goals
You make sure that I have a clear idea of our group's goals.
You set high expectations and goals; encourages others to support the organization.
You establish and document goals and objectives.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
You are a person others can trust.
You set a good example
You work in a way that makes others want to work with you.
You hold yourself accountable to goals / objectives
You set high personal standards of performance.
Negotiation	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
I am resolute on positions to provide consistency in the negotiation strategy.
I stay well-informed about the issues and priorities.
You are able to express themselves in a clear, convincing, and logical manner.
You create a decisive, team-oriented environment; clarifies goals; and outlines a strategic agenda.
You clearly explain the issues and interests at the start of negotiations.

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: