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
Analyzes interpersonal problems instead of reacting to them.
Consciously controls own negative emotions in order to keep team morale up.
Does not allow own emotions to interfere with the performance of others.
Uses patience and self-control in working with customers and associates.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Improves on their skill sets.
Pursues learning that will enhance job performance.
Takes the initiative to learn new skills.
Is open to new ideas and concepts.
Pursues professional development opportunities when they arise.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates leadership and courage in critical situations.
Acts decisively in implementing decisions.
Is a highly effective supervisor.
Sits down regularly with employees to review their job performance.
Sets a high level of performance expectations and challenges others to do the same.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adjusts plans and procedures.
Able to adapt to changes in technology and processes.
Is open to change and adjusts plans when needed.
Learns from personal experiences and/or mistakes.
Adjusts to new plans and procedures.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Attempts to persuade others rather than simply control them.
Ensures stakeholders are involved in the decision making process.
Communicates effectively with others.
Seeks to obtain consensus or compromise.
Persuades others to consider alternative points of view.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Strong organizational skills to keep the workspace and department in order
Takes responsibility for decisions.
Implements and uses performance measures.
Able to develop, justify and present a budget.
Enthusiastic about taking on challenging projects.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assigns tasks based on skills of team members.
Organizes tasks for the most efficient order of completion.
Plans and organizes continuously while performing all other responsibilities and activities.
Builds in extra time in the schedule for unplanned events/occurrences.
Switches attention to more urgent tasks when necessary.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Uses technology in decision making and problem solving.
Supports technical training and development of employees.
Supports employee training and development initiatives regarding implementation of technology.
Applies complex rules and regulations to maintain optimal system performance.
Maximizes the use of new technology to deliver products and services.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes assigned work tasks.
Responsible for setting the vision of the department.
Is a person you can trust.
Works in a way that makes others want to work with her/him.
Sets a good example.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assigns tasks that allow employees to use their critical thinking skills.
Helps employees advance their skills so that they can have more autonomy.
Gives employees the opportunity to make their own decisions at work.
Values the input from others.
Acknowledges and appreciates employees for their proactive decision-making.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides clear, motivating, and constructive feedback.
Addresses employee behavior problems effectively.
Helps employees to maintain high personal standards.
Helps employees to understand responsibilities, authority, and expectations.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Strategically deploys resources to areas of the greatest need.
Strategically focuses efforts to improve operational efficiencies.
Develops strategies that are practical and can be feasibly implemented within a reasonable period of time.
Creates a SWOT matrix to help analyze data.
Makes decisions that yield more competitive advantages.
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.
Monitors spending.
Effective in using Company's resources.
Develops of the department's annual budget.
Monitors expenses and verifies the need for items purchased.

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: