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

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Vision	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You model a strategic vision based on insights gained from in depth investigations into the performance of the company.
I am able to convert the current department vision into strategic objectives/plan.
I persuasively link departmental goals to broader organizational impact, fostering buy-in across levels.
I frame challenges and opportunities through the lens of the vision, inspiring confidence and urgency.
I concentrate employees' tasks on essential parts of the vision.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You create plans to develop and promote organizational and area strengths, as well as to address weaknesses.
You make sure employees understand the strategy and goals.
I develop a strategic focus on internal factors to improve efficiency or conserve limited resources.
I align cross-functional teams to the strategic plan.
I monitor company performance and make adjustments to the strategic plan as needed.
Accountability	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You work hard to ensure the success of the department.
I accept the consequences for my actions.
You accept accountability for your actions and results.
You take ownership of mistakes and learn from them.
You establish performance standards for the team/department.
Continual Improvement	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You look for ways to expand and learn new job skills.
You look for ways to improve work processes and procedures.
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.
You are open to the suggestions from others.
Administrative Skill	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I gather appropriate business information.
You use proper telephone etiquette.
You accurately perform data entry.
I plan travel arrangements.
I select and use training/instructional methods and procedures appropriate for the situation when learning or teaching new things.
Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You support safety programs and procedures.
You participate in safety training when available.
You are not afraid to question a potential safety issue observed in the workplace.
You point out behaviors in others that may be unsafe.
You commit adequate resources toward safety measures.
Developing Others	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You set performance objectives for subordinates that encourages development opportunities.
You create a work environment that fosters positive feedback to employees.
You assign tasks and responsibilities to develop skills of others.
You provide constructive feedback to others.
You assess employees' developmental needs.
Coaching	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I encourage the employee to see solving the issue as an opportunity to demonstrate their resourcefulness and resilience.
You ask employees to define or explain your goals, strategies, and motivations.
You ask open-ended questions to guide employees to uncover your own answers and insights rather than provide them with direct solutions.
I value the employee's perspective and individuality, which builds trust and rapport.
You help employees to maintain high personal standards.

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.