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
I view setbacks as opportunities to learn from.
You pursue professional development opportunities when they arise.
You participate in regular training offered.
You pursue learning that will enhance job performance.
You share best practices with others and learn from others.
Continual Improvement	Agree	Unsure	Disagree	N/A
You look for ways to improve work processes and procedures.
You search for new methods, techniques, and processes that increase efficiency and reduce costs.
You analyze processes to determine areas for improvement.
You promote training and development opportunities to enhance job performance.
You are open to the suggestions from others.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You make sure that employees understand how their work relates to organizational goals.
You help guide employees with prioritizing tasks.
You maintain focus when handling several problems or tasks simultaneously.
You stay focused even when under pressure and stress.
You maintain self-control when personally criticized.
Analytical	Agree	Unsure	Disagree	N/A
You identify problems and issues needing resolution.
You identify the root cause of a problem.
You identifiy opportunities for progress and innovation.
You prioritize various actions to be taken when solving a problem.
You analyze issues and reduce them to their component parts.
Initiative	Agree	Unsure	Disagree	N/A
You confront problems immediately without supervisor instructions.
I do things without being told.
You act quickly when an opportunity becomes available.
You immediately inform the supervisor of any critical incidents.
I analyze the needs of the situation and act before being told to do so.
Flexibility	Agree	Unsure	Disagree	N/A
You have the ability to pivot strategies, operations, or processes in real-time to meet new challenges or seize new opportunities.
You are willing to try new ideas.
I embrace uncertainty with confidence and creativity to find solutions amidst chaos.
I am able to adapt and tailor approaches based on the unique requirements of each scenario.
I am flexible in responding to customer needs.
Objectives	Agree	Unsure	Disagree	N/A
You assure [Company] principles are understood, employed & pursued.
You communicate goals and objectives to employees.
You consistently provide me with timely feedback for improving my performance.
You are able to organize work.
You work toward achieving established goals and objectives.
Empowering Others	Agree	Unsure	Disagree	N/A
You encourage others to obtain necessary skills and training.
You recognize the accomplishments of employees when they complete important assignments.
You give responsibility for making important decisions to employees.
You create opportunities for employees to exercise their independence.
You demonstrate confidence in the abilities of subordinates.
Others	Agree	Unsure	Disagree	N/A
You respect the opinions of other employees.
You treat others with respect and dignity.
You are able to see issues from others' perspectives.
You include others in the decision making processes.
You are able to see issues from others' perspectives.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You exhibit determination and passion in completion of goals.
You understand the processes and various stages of business development.
You take the initiative to complete tasks.
You encourage risk taking for developing potential business opportunities.
You are able to adapt the department to changing business demands and climate.

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.