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.



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Objectives	Agree	Unsure	Disagree	N/A
You effectively organize resources and plans
You organize and schedules events, activities, and resources.
You are able to establish realistic goals.
You work toward achieving established goals and objectives.
You communicate goals and objectives to employees.
Achievement	Agree	Unsure	Disagree	N/A
You use established goals and performance measures to keep track of performance.
You help others to improve or meet standards of performance.
You are able to successfully launch the ABC project.
You are able to increase customer satisfaction scores for the quarter.
I can complete training on the new equipment.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You function well under stress, deadlines, and/or significant workloads.
You help guide employees with prioritizing tasks.
You maintain self-control when personally criticized.
You stay focused even when under pressure and stress.
You set appropriate goals for employees.
Innovation	Agree	Unsure	Disagree	N/A
You embrace an open-minded approach allowing managers to discover and promote innovative solutions that drive business success.
You facilitate ongoing technical training and development to enable employees to contribute to innovative solutions.
You establish systems of continuous improvement.
You create innovative methods of developing business opportunities.
I participate in cross-functional innovation teams.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You are easily approachable.
You strive to lead by example to demonstrate the value of interpersonal relationships.
I demonstrate positive behaviors for others to follow.
I build strong relationships with team members.
I am a highly respected individual in the company.
Responsible	Agree	Unsure	Disagree	N/A
You take personal responsibility for results.
Your behavior is ethical and honest.
You set a good example
You act as a resource without removing individual responsibility.
You are a person others can trust.
Coaching	Agree	Unsure	Disagree	N/A
You conduct regular performance appraisals and feedback.
You help employees to understand responsibilities, authority, and expectations.
You address employee behavior problems effectively.
You meet regularly with employees to coach them on areas that will enhance your performance
You coach employees in how to strengthen knowledge and skills to improve work performance.
Others	Agree	Unsure	Disagree	N/A
You work across boundaries within the organization.
You are able to see issues from others' perspectives.
You include others in the decision making processes.
You form working relationships with employees from other departments.
You constructively receive criticism and suggestions from others.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You respect the views offered by individuals with different cultural backgrounds.
You are curious and willing to ask questions about the cultural differences in the workplace.
I am an advocate for others with different cultural backgrounds.
You are aware of the similarities and differences among and between cultural groups.
You maintain an inclusive work environment that maximizes the talents of others in achieving goals.
Global Perspective	Agree	Unsure	Disagree	N/A
You can effectively deliver presentations to international clients.
You are able to work with others from different cultures and countries.
You consider customers point of view when making decisions.
You apply knowledge of overseas markets.
You understand and appreciate the perspectives offered by others with different cultural backgrounds.

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.