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 take the initiative to learn new skills.
You set relevant learning objectives and goals.
You pursue self-improvement through continual learning.
I view setbacks as opportunities to learn from.
You take charge of your training and skills enhancement.
Continual Improvement	Agree	Unsure	Disagree	N/A
You look for ways to expand current job responsibilities.
You analyze processes to determine areas for improvement.
You are open to the suggestions from others.
You look for ways to expand and learn new job skills.
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 align the department's goals with the goals of the organization.
You make sure that employees understand and identify with the team's mission.
You function well under stress, deadlines, and/or significant workloads.
You make sure that employees understand how their work relates to organizational goals.
You set appropriate goals for employees.
Analytical	Agree	Unsure	Disagree	N/A
You identify problems and issues needing resolution.
You ask the "right" questions to size up or evaluate situations.
You implement data validation techniques and methods.
You identifiy opportunities for progress and innovation.
You analyze data and information from several sources and arrives at logical conclusions.
Initiative	Agree	Unsure	Disagree	N/A
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You seize upon opportunities available.
You take the initiative to change the direction or course of events.
I take charge when there is a crisis.
You take action to establish clear and concise deadlines for tasks to be completed.
Flexibility	Agree	Unsure	Disagree	N/A
You are willing to change strategies, operations, or processes in to meet new challenges or seize new opportunities.
I am able to change the workflow as needed to facilitate changes in regulations or policies.
I am able to make changes to my leadership style after receiving constructive feedback through the performance review.
I encourage open communication and collaboration, allowing everyone to contribute their ideas and perspectives.
I am flexible to manage uncertain changes in technology.
Objectives	Agree	Unsure	Disagree	N/A
You are able to organize work.
You are able to establish realistic goals.
You organize and schedules events, activities, and resources.
You establish goals and objectives.
You effectively organize resources and plans
Empowering Others	Agree	Unsure	Disagree	N/A
You express confidence in the abilities of others.
I include others in the decision making process.
You demonstrate confidence in the abilities of subordinates.
I create a culture where employees are recognized and rewarded for taking the initiative and making impactful choices.
You let employees complete tasks according to their methods.
Others	Agree	Unsure	Disagree	N/A
You are able to see issues from others' perspectives.
You support the efforts of other employees in implementing solutions to problems.
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 seek and utilize mentors to help guide your professional development.
You take the initiative to complete tasks.
You encourage risk taking for developing potential business opportunities.
You are comfortable operating in an environment of uncertainty.
You understand the processes and various stages of business development.

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.