Continual Improvement - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Continual Improvement:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)

You have been selected to provide feedback for the manager listed above. 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.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

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.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .

Continual Learning

Agree Unsure Disagree N/A
  1. Builds on their strengths while addressing their weaknesses.
  1. Shares best practices with others and learns from others.
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Pursues self-improvement through continual learning.
  1. Sets relevant learning objectives and goals.

Continual Improvement

Agree Unsure Disagree N/A
  1. Promotes training and development opportunities to enhance job performance.
  1. Looks for ways to expand current job responsibilities.
  1. Looks for ways to improve work processes and procedures.
  1. Looks for ways to expand and learn new job skills.
  1. Open to the suggestions from others.

Establishing Focus/Direction

Agree Unsure Disagree N/A
  1. Aligns the department's goals with the goals of the organization.
  1. Excellent at managing time.
  1. Stays focused even when under pressure and stress.
  1. Helps guide employees with prioritizing tasks.
  1. Sets appropriate goals for employees.


Agree Unsure Disagree N/A
  1. Analyzes data and information from several sources and arrives at logical conclusions.
  1. Uses appropriate techniques to solve problems.
  1. Asks the "right" questions to size up or evaluate situations.
  1. Identifies the root cause of a problem.
  1. Actively seeks constructive feedback from others.


Agree Unsure Disagree N/A
  1. Immediately works to complete goals well before their deadline.
  1. Takes action without being asked.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Takes the initiative to change the direction or course of events.
  1. Prepares for unexpected contingencies.


Agree Unsure Disagree N/A
  1. Adapts to circumstances as needed.
  1. Encourages others to adopt new procedures.
  1. Willing to try new ideas.
  1. Open to the perspectives/viewpoints of others.
  1. Can handle changes without complaining.


Agree Unsure Disagree N/A
  1. Encourages me to take on greater responsibility.
  1. Able to organize work.
  1. Effectively organizes resources and plans
  1. Sets long-term and short-term goals.
  1. Organizes and schedules events, activities, and resources.

Empowering Others

Agree Unsure Disagree N/A
  1. Sets clear goals for others to accomplish.
  1. Encourages others to obtain necessary skills and training.
  1. Distributes the workload to subordinates.
  1. Encourages employees to solve problems on their own.
  1. Provides support and resources needed to accomplish goals.


Agree Unsure Disagree N/A
  1. Constructively receives criticism and suggestions from others.
  1. Works effectively with people from other departments.
  1. Forms working relationships with employees from other departments.
  1. Is able to see issues from others' perspectives.
  1. Supports the efforts of other employees in implementing solutions to problems.


Agree Unsure Disagree N/A
  1. Excellent at managing relationships with stakeholders.
  1. Able to adapt the department to changing business demands and climate.
  1. Has a strategic awareness on how to promote the organization.
  1. Encourages dynamic growth opportunities.
  1. Finds unique ways to go around barriers to success.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.