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 build on your strengths while addressing your weaknesses.
You pursue self-improvement through continual learning.
You seek opportunities to grow in skills and knowledge.
I view setbacks as opportunities to learn from.
You participate in regular training offered.
Continual Improvement	Agree	Unsure	Disagree	N/A
You promote training and development opportunities to enhance job performance.
You analyze processes to determine areas for improvement.
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.
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 stay focused even when under pressure and stress.
You help guide employees with prioritizing tasks.
You are excellent at managing time.
You set appropriate goals for employees.
You function well under stress, deadlines, and/or significant workloads.
Analytical	Agree	Unsure	Disagree	N/A
You identify the root cause of a problem.
You balance risks and costs with the reward and probabilities of success when decisions.
You implement data validation techniques and methods.
You identify problems and issues needing resolution.
You use appropriate techniques to solve problems.
Initiative	Agree	Unsure	Disagree	N/A
I build strong interpersonal relationships upon first meeting.
I clean the workspace without being told.
You quickly come to the aid of those who may need help.
You seize upon opportunities available.
You are a self-starter. You do not wait to be told to do something.
Flexibility	Agree	Unsure	Disagree	N/A
You implement changes as a result of having listened to employees
You adapt to circumstances as needed.
You are open to alternative ways to accomplish goals
You identify new opportunities to achieve goals
You are open to the perspectives/viewpoints of others.
Objectives	Agree	Unsure	Disagree	N/A
You communicate goals and objectives to employees.
You assure [Company] principles are understood, employed & pursued.
You are able to establish realistic goals.
You establish goals and objectives.
You organize and schedules events, activities, and resources.
Empowering Others	Agree	Unsure	Disagree	N/A
I support the decisions of others even if those decisions may sometimes lead to mistakes.
I set goals to allow the employees to have more autonomy over their work.
I coordinate the knowledge, skills and resources of others to accomplish more in the department.
I give employees important tasks to expand their career options.
I allow for flexibility in the working hours.
Others	Agree	Unsure	Disagree	N/A
You work effectively with people from other departments.
You respect the opinions of other employees.
You include others in the decision making processes.
You support the efforts of other employees in implementing solutions to problems.
You are able to see issues from others' perspectives.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You take the initiative to complete tasks.
You encourage risk taking for developing potential business opportunities.
You are able to adapt the department to changing business demands and climate.
You are comfortable operating in an environment of uncertainty.
You maintain a high level of energy to respond to demands of the job.

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.