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
I can chart a bold course for the department's evolution.
You craft strategic plans that embody the organization's shared vision.
You develop a vision that is a catalyst for innovation and change.
I provide staff with the necessary resources, authority, and support to effectively implement and achieve the organization's vision.
I task employees with realizing the vision.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I identify and understand competitors in the marketplace.
I align cross-functional teams to the strategic plan.
You ensure that the department's goals are strategically aligned with the company's goals.
You create a SWOT matrix to help analyze data.
I identify sources for developing a global competitive advantage for the company.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I regularly lead the way when helping the team troubleshoot various issues.
You take charge of addressing and solving problems.
I maintain honesty and transparency in all communications.
I accept personal responsibility for producing high quality and timely work.
You consistently follow through on commitments and promises.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You promote training and development opportunities to enhance job performance.
You are open to the suggestions from others.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You look for ways to expand current job responsibilities.
You analyze processes to determine areas for improvement.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are enthusiastic about taking on challenging projects.
You have strong organizational skills to keep the workspace and department in order
You have a high attention to detail.
You accurately implement contract provisions.
You have strong technical/computer skills.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop safety guidelines for the department.
You develop a culture of safety.
You participate in safety training as applicable.
You are committed to safety in the workplace.
You mitigate hazards and safety issues that arise.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You encourage employees through recognition of positive changes in behavior.
You support the successes of other employees.
You set performance objectives for subordinates that encourages development opportunities.
You develop employees by offering and encouraging them to take on new or additional responsibilities.
You are open to receiving feedback.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You meet regularly with employees to coach them on areas that will enhance your performance
You address employee behavior problems effectively.
You coach employees in how to strengthen knowledge and skills to improve work performance.
You help employees to understand responsibilities, authority, and expectations.
You provide clear, motivating, and constructive feedback.

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.