Excellence - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. 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.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

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Excellence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You objectively analyze performance to understand what is working and what needs improvement.
You demonstrate the analytical skills to do your job.
You use objective measures to evaluate how well goals are being met.
You build and maintain relationships with industry colleagues that support shared learning and improved performance.
You maintain a list of professional business contacts in the industry.
If you were to make improvements in Excellence, what are your suggestions for how you can improve this?
Establishing Focus/Direction	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I analyze metrics such as project completion rates, quality of work, or customer satisfaction scores.
You schedule regular one-on-one meetings with employees to help give focus and direction.
I develop shift patterns or schedules to maximize productivity while addressing individual availability.
You mentor and help team members stay on track through guidance and collaboration.
You tailor guidance and support based on individual strengths, challenges, or circumstances.
If you were to make improvements in Establishing Focus/Direction, what are your suggestions for how you can improve this?
Quality	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I solve quality control issues.
I effectively coordinate with other departments to improve quality.
I assist quality control inspectors.
I model craftsmanship and care, demonstrating that quality is not just a goal but a personal standard.
You adapt quality processes or inspection methods when conditions change.
If you were to make improvements in Quality, what are your suggestions for how you can improve this?
Juggling Multiple Responsibilities	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I align task prioritization with strategic goals, deadlines, and stakeholder impact.
You keep track of multiple assignments and deadlines.
You encourage team members to take initiative by assigning tasks that challenge their current capabilities.
You plan and organize continuously while performing all other responsibilities and activities.
I transition between administrative, operational, and interpersonal tasks without losing momentum or clarity.
If you were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how you can improve this?
Customer Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You make customer's needs a top priority.
I am committed to the success of the customer.
I use product expertise to guide customers toward a satisfy choice.
You are pro-active in dealing with customers and addressing your needs.
I respond to feedback from customers.
If you were to make improvements in Customer Focus, what are your suggestions for how you can improve this?
Negotiation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You are resolute in positions to build trust and predictability.
I listen to all sides without bias and make fair decisions.
I always have a "game plan" prior to entering into negotiations.
You do what it takes to ensure that the final agreement aligns with core interests.
You shift negotiation tactics when other priorities or constraints become clearer, adjusting the approach to maintain progress.
If you were to make improvements in Negotiation, what are your suggestions for how you can improve this?
Strategic Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I am effective in using strategic tools such as value chain analysis, business environment analysis, and competitor analysis.
You ensure that the department's goals are strategically aligned with the company's goals.
I create innovative strategies.
You create deadlines for various components of the strategy.
You assign individuals the responsibility of keeping track of progress toward achieving milestones.
If you were to make improvements in Strategic Focus, what are your suggestions for how you can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.