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
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
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.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Takes charge of their training and skills enhancement.
Pursues professional development opportunities when they arise.
Participates in regular training offered.
Grasps new ideas, concepts, technical, or business knowledge.
Takes the initiative to learn new skills.
Leadership	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
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.
Able to influence others.
Effectively leads others.
Demonstrates leadership and courage in critical situations.
Highly effective supervisor.
Adaptability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Is proactive and takes steps to prepare for changes in the workplace.
Recognizes and implements changes to enhance efficiency and effectiveness.
Learns from personal experiences and/or mistakes.
Able to quickly learn new ways of performing their job.
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.
Able to express own goals and needs.
Seeks to obtain consensus or compromise.
Develops a good rapport with others.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
High attention to detail.
Strong organizational skills to keep the workspace and department in order
Implements and uses performance measures.
Has strong technical/computer skills.
Able to develop, justify and present a budget.
Juggling Multiple Responsibilities	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
Plans and organizes continuously while performing all other responsibilities and activities.
Bounces back from daily crisis, disappointments and frustrations.
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.
Uses technology in decision making and problem solving.
Understands and is committed to implementing new technologies.
Maximizes the use of new technology to deliver products and services.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Responsible	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...takes personal responsibility for results.
Behavior is ethical and honest.
Acts as a resource without removing individual responsibility.
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Empowering Others	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets clear goals for others to accomplish.
Provides support and resources needed to accomplish goals.
Avoids micromanaging their employees.
Encourages employees to solve problems on their own.
Distributes the workload to subordinates.
Coaching	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides clear, motivating, and constructive feedback.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Conducts regular performance appraisals and feedback.
Helps employees to maintain high personal standards.
Addresses employee behavior problems effectively.
Strategic Focus	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands their role within the organization.
Communicates goals and objectives to employees.
Able to decline a poor strategy by proposing alternate strategies.
Understands & contributes to development of strategic goals.
Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
Fiscal Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops budgets and plans for various programs and initiatives.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Ensures others follow the correct rules and regulations on fiscal matters.
Provides budgeting and accounting support to the Company.
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: