Continuous 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.
I view setbacks as opportunities to learn from.
You pursue learning that will enhance job performance.
You build on your strengths while addressing your weaknesses.
You set relevant learning objectives and goals.
Continuous Improvement	Agree	Unsure	Disagree	N/A
I identify subtle inefficiencies in equipment or workflow that require expert understanding to detect and correct.
I promote cross-functional projects that build awareness of operational interdependencies.
I focus on reducing customer dissatisfaction.
I streamline processes by removing non-value-added steps to reduce cycle times and improve flow.
You share newly learned techniques or insights with coworkers to strengthen team capability and spread best practices.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
I create opportunities for peer learning and collaborative problem-solving.
I identify early signs of misalignment and intervene to restore focus and direction.
I schedule regular check-ins and 'roundings' where employees can discuss their goals, preferences, and any areas where they need support.
You develop contingency plans to proactively address potential risks.
You allocate time, personnel, and tools based on task complexity and team capacity.
Analytical	Agree	Unsure	Disagree	N/A
I am able to dissect a problem into its core elements.
I identify potential problem areas.
You analyze data to meet the needs of your clients.
You gather information from a variety of sources.
I create presentations that are straight forward to understand.
Initiative	Agree	Unsure	Disagree	N/A
I look for opportunities to move projects forward.
You prepare for unexpected contingencies.
I take on additional tasks without being asked or told to do so.
I begin a task and follow through until completion.
You persist in stakeholder engagement even when initial outreach is met with resistance or indifference.
Flexibility	Agree	Unsure	Disagree	N/A
You are flexible to manage uncertain changes in the financial landscape.
You foster a culture of agility, ensuring that the team can thrive amidst constant change and uncertainty.
You respond to changing availability of supplies and resources.
You are willing to deviate from rigid plans and consider a variety of methods, ensuring the most effective solution is applied.
You adapt to circumstances as needed.
Objectives	Agree	Unsure	Disagree	N/A
You consistently provide me with timely feedback for improving my performance.
You are able to organize work.
You establish goals and objectives.
You organize and schedules events, activities, and resources.
You work toward achieving established goals and objectives.
Empowering Others	Agree	Unsure	Disagree	N/A
I allow employees to take on more responsibilities.
You set clear goals for assignments.
You provide opportunities for employee development and growth.
You listen to the ideas employees have for solving issues.
You distribute the workload to subordinates.
Others	Agree	Unsure	Disagree	N/A
You treat others with respect and dignity.
You respect the opinions of other employees.
You form working relationships with employees from other departments.
You are able to see issues from others' perspectives.
You consistently demonstrate ability and willingness to trust others.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You exhibit determination and passion in completion of goals.
You seek and utilize mentors to help guide your professional development.
You maintain a high level of energy to respond to demands of the job.
You devote a certain amount of time and effort to developing new business opportunities.
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.