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 lead employees in new directions.
You create a positive vision of the future for the Company.
You communicate the vision and strategy of [Company]
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
You are able to decline a poor strategy by proposing alternate strategies.
You communicate goals and objectives to employees.
You understand and contribute to development of strategic goals.
You focus attention on treating the causes of problems rather than simply addressing the symptoms.
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You define roles, rights, and responsibilities of the team.
You keep you supervisor informed of recent events.
You act like an owner when they make decisions.
You develop goals and establishes objective measures of success.
You tackle issues head on and finds solutions.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You look for ways to expand and learn new job skills.
You are open to the suggestions from others.
You look for ways to expand current job responsibilities.
You look for ways to improve work processes and procedures.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You have strong technical/computer skills.
You take responsibility for decisions.
You implement and use performance measures.
You are able to develop, justify and present a budget.
You are enthusiastic about taking on challenging projects.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You point out behaviors in others that may be unsafe.
You ensure that all supervisors are aware of regulatory and compliance measures.
You seek to reduce the likelihood of accidents.
You participate in safety training when available.
You are aware of osha safety guidelines.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You try to ensure employees are ready to move to the next level.
You are open to receiving feedback.
You create a work environment that fosters positive feedback to employees.
You set performance objectives for subordinates that encourages development opportunities.
You assess employees' developmental needs.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You coach employees in how to strengthen knowledge and skills to improve work performance.
You help employees to understand responsibilities, authority, and expectations.
You meet regularly with employees to coach them on areas that will enhance your performance
You conduct regular performance appraisals and feedback.
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.