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
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Uses patience and self-control in working with customers and associates.
Consciously controls own negative emotions in order to keep team morale up.
Analyzes interpersonal problems instead of reacting to them.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Views setbacks as opportunities to learn from.
Builds on their strengths while addressing their weaknesses.
Sets relevant learning objectives and goals.
Shares best practices with others and learns from others.
Improves on their skill sets.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to influence others.
Takes ownership and accountability for results
Expresses clear goals and objectives.
Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
Acts decisively in implementing decisions.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adjusts tactics when things are not working as expected.
Flexible and open to new ideas and encourages others to recognize the value of change.
Is flexible when dealing with changes.
Adjusts plans to meet new situations.
Handles unexpected events without a loss of productivity.
Persuasion and Influence	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has excellent influencing/negotiating skills.
Ensures stakeholders are involved in the decision making process.
Understanding what others need.
Communicates effectively with others.
Develops a good rapport with others.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements and uses performance measures.
Enthusiastic about taking on challenging projects.
Able to develop, justify and present a budget.
High attention to detail.
Strong organizational skills to keep the workspace and department in order
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assigns tasks based on skills of team members.
Switches attention to more urgent tasks when necessary.
Builds in extra time in the schedule for unplanned events/occurrences.
Begins tasks as soon as possible.
Is aware of the deadlines for specific tasks/assignments.
Technology Use/Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adopts the implementation of new technology into the workplace.
Supports technical training and development of employees.
Applies complex rules and regulations to maintain optimal system performance.
Supports employee training and development initiatives regarding implementation of technology.
Uses technology in decision making and problem solving.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds herself / himself accountable to goals / objectives
Sets high personal standards of performance.
Sets a good example.
Sets a good example
Completes assigned work tasks.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Values the input from others.
Considers ideas from employees that may challenge traditional ways of doing the job.
Allows employees to make their own decisions.
Helps employees advance their skills so that they can have more autonomy.
Allows employees the opportunity to take time off when needed.
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.
Helps employees to maintain high personal standards.
Provides clear, motivating, and constructive feedback.
Helps employees to understand responsibilities, authority, and expectations.
Meets regularly with employees to coach them on areas that will enhance their performance
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Looks for opportunities to enhance contributions to the bottom line.
Recognizes the need for strategically developing unique capabilities.
Strategically positions resources to meet the needs of field based employees.
Communicates goals and objectives to employees.
Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
Fiscal Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Keeps excellent records for financial transparency.
Effective in using Company's resources.
Ensures others follow the correct rules and regulations on fiscal matters.
Provides budgeting and accounting support to the Company.
Develops of the department's annual budget.

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: