Self-Management - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

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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Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Consciously controls own negative emotions in order to keep team morale up.
Does not allow own emotions to interfere with the performance of others.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Analyzes interpersonal problems instead of reacting to them.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Participates in regular training offered.
Sets relevant learning objectives and goals.
Takes charge of their training and skills enhancement.
Pursues learning that will enhance job performance.
Seeks opportunities to grow in skills and knowledge.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds others accountable for their actions.
Guides decision-making by coaching, counseling and rewarding.
Takes ownership and accountability for results
Recognizes individual and team accomplishments and reward them appropriately.
Sets specific, measurable, and challenging goals.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Accommodates changes as needed.
Learns from personal experiences and/or mistakes.
Is open to change and adjusts plans when needed.
Is aware of changes to team personnel.
Handles changes easily.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has excellent influencing/negotiating skills.
Persuades others to consider alternative points of view.
Ensures stakeholders are involved in the decision making process.
Attempts to persuade others rather than simply control them.
Able to express own goals and needs.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Enthusiastic about taking on challenging projects.
Able to develop, justify and present a budget.
Has strong technical/computer skills.
Takes responsibility for decisions.
Completes reports on-time.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of the deadlines for specific tasks/assignments.
Determines which tasks are critical and which tasks are optional.
Begins tasks as soon as possible.
Plans and organizes continuously while performing all other responsibilities and activities.
Keeps track of multiple assignments and deadlines.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Applies complex rules and regulations to maintain optimal system performance.
Maximizes the use of new technology to deliver products and services.
Supports employee training and development initiatives regarding implementation of technology.
Adopts the implementation of new technology into the workplace.
Understands and is committed to implementing new technologies.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a good example
Is a person you can trust.
Sets a good example.
Sets high personal standards of performance.
Acts as a resource without removing individual responsibility.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Encourages employees to take the initiative when responding to an issue.
Fosters a sense of ownership and accountability for the process/product.
Gives employees opportunities to demonstrate their skills.
Values the input from others.
Provides support and resources needed to accomplish goals.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Develops the skills and capabilities of others.
Provides clear, motivating, and constructive feedback.
Helps employees to maintain high personal standards.
Conducts regular performance appraisals and feedback.
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Mobilizes change through executive leadership to implement corporate strategies.
Crafts and executes strategies to advance the company.
Creates a strategy to achieve departmental objectives.
Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
Implements and executes the company's strategy for advancing production capabilities.
Fiscal Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures others follow the correct rules and regulations on fiscal matters.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Develops budgets and plans for various programs and initiatives.
Keeps excellent records for financial transparency.
Provides budgeting and accounting support to the Company.

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

    -Excellent -Good -Average -Poor




67. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
68. 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?
    
    
    
69. What changes do you see [Company] making in order to raise the standards?
    
    
    
70. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
71. What do you like best about working for [Company]?
    
    
    
72. 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: