Continual Improvement - 360 Degree Feedback Survey Sample #8

Self-Assessment Instructions

You have been selected to complete a self-assessment questionnaire as part of a 360-degree feedback assessment. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

Respond to the assessment form based on your work experiences during the previous 12 months. Your responses will be merged with other people's feedback and presented to you in your on-going development. Comments from others will be shared anonymously, as written.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Continual Learning	Agree	Unsure	Disagree	N/A
You grasp new ideas, concepts, technical, or business knowledge.
You improve on your skill sets.
You participate in regular training offered.
I view setbacks as opportunities to learn from.
You take charge of your training and skills enhancement.
Continual Improvement	Agree	Unsure	Disagree	N/A
You analyze processes to determine areas for improvement.
You promote training and development opportunities to enhance job performance.
You are open to the suggestions from others.
You look for ways to expand and learn new job skills.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You are excellent at managing time.
You stay focused even when under pressure and stress.
You set appropriate goals for employees.
You make sure that employees understand and identify with the team's mission.
You maintain focus when handling several problems or tasks simultaneously.
Analytical	Agree	Unsure	Disagree	N/A
You analyze issues and reduce them to their component parts.
You select the appropriate techniques for analysis.
You identifiy opportunities for progress and innovation.
You ask the "right" questions to size up or evaluate situations.
You use appropriate techniques to solve problems.
Initiative	Agree	Unsure	Disagree	N/A
I address small problems before they become big ones.
You seek and utilize opportunities for continuous learning and self-development.
You initiate draft documents for the director.
You independently seek out new learning opportunities to improve your skills.
You take action to establish clear and concise deadlines for tasks to be completed.
Flexibility	Agree	Unsure	Disagree	N/A
You can handle changes without complaining.
You are open to the perspectives/viewpoints of others.
You are able to adapt to new situations.
You work effectively during periods of change.
You act decisively in frequently changing and uncertain environment.
Objectives	Agree	Unsure	Disagree	N/A
You assure [Company] principles are understood, employed & pursued.
You effectively organize resources and plans
You set long-term and short-term goals.
You work toward achieving established goals and objectives.
You communicate goals and objectives to employees.
Empowering Others	Agree	Unsure	Disagree	N/A
You trust employees to complete tasks assigned.
You let employees complete tasks according to their methods.
You avoid micromanaging your employees.
You recognize the accomplishments of employees when they complete important assignments.
You allow employees to have flexible work schedules.
Others	Agree	Unsure	Disagree	N/A
You treat others with respect and dignity.
You support the efforts of other employees in implementing solutions to problems.
You work across boundaries within the organization.
You treat others with respect and dignity.
You form working relationships with employees from other departments.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You understand the processes and various stages of business development.
You devote a certain amount of time and effort to developing new business opportunities.
You can work effectively in an environment of uncertainty.
You find unique ways to go around barriers to success.
You seek and utilize mentors to help guide your professional development.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.