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 .

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Continual Learning	Agree	Unsure	Disagree	N/A
You improve on your skill sets.
You pursue self-improvement through continual learning.
I view setbacks as opportunities to learn from.
You pursue professional development opportunities when they arise.
You pursue learning that will enhance job performance.
Continual Improvement	Agree	Unsure	Disagree	N/A
You look for ways to expand and learn new job skills.
You look for ways to improve work processes and procedures.
You analyze processes to determine areas for improvement.
You promote training and development opportunities to enhance job performance.
You look for ways to expand current job responsibilities.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You make sure that employees understand how their work relates to organizational goals.
You stay focused even when under pressure and stress.
You make sure that employees understand and identify with the team's mission.
You are excellent at managing time.
You maintain self-control when personally criticized.
Analytical	Agree	Unsure	Disagree	N/A
I evaluate whether the information is specific enough to be meaningful.
I look at problems from different perspectives and viewpoints.
You check the credibility of information sources.
You understand complex issues and problems.
I create detailed budgets that guide financial planning and decision-making.
Initiative	Agree	Unsure	Disagree	N/A
I initiate the development of new products.
You seize upon opportunities available.
I do things without being told.
I initiate projects that have an impact on the department.
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
Flexibility	Agree	Unsure	Disagree	N/A
You adapt to new organizational structures, policies, or procedures.
I respond to changing governmental regulations.
I am flexible in my approach to dealing with unpredictable events.
I am able to work in multiple environments as needed.
You adapt easily to incorporate various perspectives.
Objectives	Agree	Unsure	Disagree	N/A
You set long-term and short-term goals.
You assure [Company] principles are understood, employed & pursued.
You effectively organize resources and plans
You establish goals and objectives.
You consistently provide me with timely feedback for improving my performance.
Empowering Others	Agree	Unsure	Disagree	N/A
I foster a sense of ownership and accountability for the process/product.
You set clear goals for others to accomplish.
You listen to the ideas employees have for solving issues.
You give responsibility for making important decisions to employees.
You create opportunities for employees to exercise their independence.
Others	Agree	Unsure	Disagree	N/A
You include others in the decision making processes.
You constructively receive criticism and suggestions from others.
You work across boundaries within the organization.
You support the efforts of other employees in implementing solutions to problems.
You treat others with respect and dignity.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You understand the processes and various stages of business development.
You balance risks and rewards when making decisions.
You have a strategic awareness on how to promote the organization.
You are able to adapt the department to changing business demands and climate.
You take the initiative to complete tasks.

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.