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 improve on your skill sets.
You take the initiative to learn new skills.
You share best practices with others and learn from others.
You take charge of your training and skills enhancement.
You are open to new ideas and concepts.
Continual Improvement	Agree	Unsure	Disagree	N/A
You analyze processes to determine areas for improvement.
You look for ways to expand and learn new job skills.
You promote training and development opportunities to enhance job performance.
You look for ways to improve work processes and procedures.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You make sure that employees understand how their work relates to organizational goals.
You align the department's goals with the goals of the organization.
You help guide employees with prioritizing tasks.
You make sure that employees understand and identify with the team's mission.
You set appropriate goals for employees.
Analytical	Agree	Unsure	Disagree	N/A
You select the appropriate techniques for analysis.
You balance risks and costs with the reward and probabilities of success when decisions.
You analyze issues and reduce them to their component parts.
You identify problems and issues needing resolution.
You identifiy opportunities for progress and innovation.
Initiative	Agree	Unsure	Disagree	N/A
You volunteer your time and effort toward the completion of important goals.
You complete tasks without having to be told to do so.
You take the initiative to complete tasks ahead of schedule.
You take corrective action to address performance deficiencies/issues.
You go above and beyond the stated goals.
Flexibility	Agree	Unsure	Disagree	N/A
You accommodate the needs of employees as best as possible when requests for time off are made.
You allow for flexibility in the agenda for the team meeting.
You are capable of adapting workflows to accommodate new regulations or policies.
You adapt quickly to new technologies that impact the production line.
I embrace change, values feedback, and is willing to experiment with different methods to find the most effective solutions.
Objectives	Agree	Unsure	Disagree	N/A
You effectively organize resources and plans
You encourage others to take on greater responsibility.
You organize and schedules events, activities, and resources.
You communicate goals and objectives to employees.
You establish goals and objectives.
Empowering Others	Agree	Unsure	Disagree	N/A
I recognize the expertise that employees have in certain areas and allow them the freedom to operate as they see fit.
You distribute the workload to subordinates.
You give employees input into the decision making process.
You set clear goals for others to accomplish.
I help employees advance their skills so that they can have more autonomy.
Others	Agree	Unsure	Disagree	N/A
You form working relationships with employees from other departments.
You include others in the decision making processes.
You treat others with respect and dignity.
You consistently demonstrate ability and willingness to trust others.
You are able to see issues from others' perspectives.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You are able to adapt the department to changing business demands and climate.
You balance risks and rewards when making decisions.
You encourage risk taking for developing potential business opportunities.
You find unique ways to go around barriers to success.
You are excellent at managing relationships with stakeholders.

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.