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 set relevant learning objectives and goals.
You participate in regular training offered.
You seek opportunities to grow in skills and knowledge.
You improve on your skill sets.
You are open to new ideas and concepts.
Continual Improvement	Agree	Unsure	Disagree	N/A
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You analyze processes to determine areas for improvement.
You look for ways to expand current job responsibilities.
You encourage an employee culture of continuous improvement to seek out better ways of doing things.
You look for ways to expand and learn new job skills.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You are excellent at managing time.
You help guide employees with prioritizing tasks.
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 stay focused even when under pressure and stress.
Analytical	Agree	Unsure	Disagree	N/A
You implement data validation techniques and methods.
You identifiy opportunities for progress and innovation.
You identify problems and issues needing resolution.
You ask the "right" questions to size up or evaluate situations.
You use appropriate techniques to solve problems.
Initiative	Agree	Unsure	Disagree	N/A
You act with urgency when time is limited.
You are proactive when preparing for potential problems or critical events.
You confront problems immediately without supervisor instructions.
I inform the manager of any important changes in the equipment operation.
I look to start work on new projects without waiting for direction from the manager.
Flexibility	Agree	Unsure	Disagree	N/A
You are able to bounce back from obstacles.
You are dedicated to evolving and enhancing business processes, which demonstrates flexibility.
You demonstrate flexibility in thoughts and actions.
You foster a culture of agility, ensuring that the team can thrive amidst constant change and uncertainty.
You respond to issues and problems with creative solutions and innovation.
Objectives	Agree	Unsure	Disagree	N/A
You assure [Company] principles are understood, employed & pursued.
You consistently provide me with timely feedback for improving my performance.
You work toward achieving established goals and objectives.
You are able to establish realistic goals.
You are able to organize work.
Empowering Others	Agree	Unsure	Disagree	N/A
I give employees opportunities to demonstrate their skills.
I give employees the authority to act on their own.
I encourage employees to take on greater responsibilities.
I assign important tasks to subordinates.
I acknowledge and appreciate employees for their proactive decision-making.
Others	Agree	Unsure	Disagree	N/A
You consistently demonstrate ability and willingness to trust others.
You treat others with respect and dignity.
You respect the opinions of other employees.
You include others in the decision making processes.
You work effectively with people from other departments.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You are comfortable operating in an environment of uncertainty.
You have a strategic awareness on how to promote the organization.
You can work effectively in an environment of uncertainty.
You are excellent at managing relationships with stakeholders.
You balance risks and rewards when making decisions.

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.