Vision- 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You express the Company vision in a way that is easily understood and adopted by employees.
You lead employees in new directions.
You persuade others to follow the Company's vision.
You demonstrate consistency between words and actions
You work to support the strategy of [Company]
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I make sure that all departments/teams are contributing toward the success of the strategy.
I make strategic decisions to optimize the returns on capital investments.
You develop a corporate strategy to establish business operations in different locations.
You make decisions that yield more competitive advantages.
You strategically position resources to meet the needs of field based employees.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I take responsibility for errors and actively work to correct them.
You hold yourself and others accountable for meeting the deadline.
I take full responsibility for unmet expectations and make corrective actions immediately.
You consult with the supervisor before engaging in new procedures that have some risk.
I regularly lead the way when helping the team troubleshoot various issues.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You look for ways to improve work processes and procedures.
You analyze processes to determine areas for improvement.
You look for ways to expand current job responsibilities.
You promote training and development opportunities to enhance job performance.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You complete reports on-time.
You are able to develop, justify and present a budget.
You take responsibility for decisions.
You have a high attention to detail.
You implement and use performance measures.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You ensure that all supervisors are aware of regulatory and compliance measures.
You are not afraid to question a potential safety issue observed in the workplace.
You develop a strong safety culture.
You work to implement corrective safety measures.
You develop safety guidelines for the department.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You assign tasks and responsibilities to develop skills of others.
You encourage employees through recognition of positive changes in behavior.
You set performance objectives for subordinates that encourages development opportunities.
You provide constructive feedback to others.
You support the successes of other employees.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You help employees to understand responsibilities, authority, and expectations.
You address employee behavior problems effectively.
You meet regularly with employees to coach them on areas that will enhance your performance
You coach employees in how to strengthen knowledge and skills to improve work performance.
You develop the skills and capabilities of others.

41. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.