Objectives - 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 .

Objectives	Agree	Unsure	Disagree	N/A
You communicate goals and objectives to employees.
You work toward achieving established goals and objectives.
You effectively organize resources and plans
You are able to establish realistic goals.
You are able to organize work.
Achievement	Agree	Unsure	Disagree	N/A
You take calculated risks to achieve higher levels of performance.
You rapidly complete tasks and assignments.
You are driven to complete assignments on time.
You strive to exceed standards of performance.
You demonstrate a well-organized and timely approach to achieve desired results
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You set appropriate goals for employees.
You function well under stress, deadlines, and/or significant workloads.
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.
Innovation	Agree	Unsure	Disagree	N/A
You challenge current procedures to develop other alternatives.
You develop new products and services.
You analyze current procedures and identify opportunities for improvement.
You take risks to advance important ideas.
You find creative ways to get things done with limited resources.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You successfully resolve conflicts and grievances to a win-win solution.
You anticipate the concerns of other employees.
You apply appropriate communication techniques to the situation.
You demonstrate compassion and understanding of others.
You come across as credible, knowledgeable and sincere
Responsible	Agree	Unsure	Disagree	N/A
You act as a resource without removing individual responsibility.
You set a good example
Your behavior is ethical and honest.
You hold yourself accountable to goals / objectives
You work in a way that makes others want to work with you.
Coaching	Agree	Unsure	Disagree	N/A
You provide clear, motivating, and constructive feedback.
You conduct regular performance appraisals and feedback.
You meet regularly with employees to coach them on areas that will enhance your performance
You help employees to understand responsibilities, authority, and expectations.
You coach employees in how to strengthen knowledge and skills to improve work performance.
Others	Agree	Unsure	Disagree	N/A
You are able to see issues from others' perspectives.
You consistently demonstrate ability and willingness to trust others.
You form working relationships with employees from other departments.
You support the efforts of other employees in implementing solutions to problems.
You constructively receive criticism and suggestions from others.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You value the opinions of diverse groups and individual.
You foster a diverse workforce free from discrimination and harassment.
You recognize and value individual and cultural differences.
You maintain an inclusive work environment that maximizes the talents of others in achieving goals.
You show respect in daily interactions
Global Perspective	Agree	Unsure	Disagree	N/A
You respect individual differences.
You form strong client relationships with international partners.
You apply knowledge of overseas markets.
You understand global systems such as the global economy.
You understand how cultures differ and how these differences impact work behavior.

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.