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 participate in regular training offered.
You pursue learning that will enhance job performance.
You share best practices with others and learn from others.
You take charge of your training and skills enhancement.
You grasp new ideas, concepts, technical, or business knowledge.
Continual Improvement	Agree	Unsure	Disagree	N/A
You look for ways to expand current job responsibilities.
You are open to the suggestions from others.
You promote training and development opportunities to enhance job performance.
You analyze processes to determine areas for improvement.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
I set timelines, roles, responsibilities, and resources required to achieve the goal.
I set deadlines and key milestones to guide the team's progress.
You listen to employee input and adapt direction to reflect frontline realities.
I schedule regular check-ins and 'roundings' where employees can discuss their goals, preferences, and any areas where they need support.
I use real-time feedback to recalibrate performance expectations when needed.
Analytical	Agree	Unsure	Disagree	N/A
I develop quantitative measures of performance.
You are comfortable working with numbers and data.
I create new ways of interpreting the data.
You create new visualizations of the data.
You implement data validation techniques and methods.
Initiative	Agree	Unsure	Disagree	N/A
I take actions without having to be told to do so.
When working on a problem in a team, I often am the first to suggest possible solutions.
I will continue to work on a problem even in the face of obstacles.
You take on extra projects after required work is completed.
You initiate new projects for the department.
Flexibility	Agree	Unsure	Disagree	N/A
You foster a culture of agility, ensuring that the team can thrive amidst constant change and uncertainty.
You are willing to try new ideas.
You are capable of adapting workflows to accommodate new regulations or policies.
You create innovative solutions to unforeseen problems.
I respond positively to unanticipated changes in the work schedule.
Objectives	Agree	Unsure	Disagree	N/A
You encourage others to take on greater responsibility.
You organize and schedules events, activities, and resources.
You are able to organize work.
You assure [Company] principles are understood, employed & pursued.
You consistently provide me with timely feedback for improving my performance.
Empowering Others	Agree	Unsure	Disagree	N/A
You give employees the opportunity to make their own decisions at work.
You allow individuals to be responsible for their decisions.
I value the expertise that others bring to the team.
I assign tasks that allow employees to use their critical thinking skills.
I value the input from others.
Others	Agree	Unsure	Disagree	N/A
You consistently demonstrate ability and willingness to trust others.
You treat others with respect and dignity.
You form working relationships with employees from other departments.
You include others in the decision making processes.
You treat others with respect and dignity.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You encourage dynamic growth opportunities.
You find unique ways to go around barriers to success.
You take the initiative to complete tasks.
You understand the processes and various stages of business development.
You have a strategic awareness on how to promote the organization.

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.