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 are able to establish realistic goals.
You set long-term and short-term goals.
You are able to organize work.
You organize and schedules events, activities, and resources.
You assure [Company] principles are understood, employed & pursued.
Achievement	Agree	Unsure	Disagree	N/A
You always work to improve the process and procedures.
You champion process improvements that enhance productivity, compliance, and overall success.
I set ambitious yet achievable goals, motivating others to strive for excellence.
You align individual and team aspirations with organizational goals through strategic goal setting.
You leverage the strengths and expertise of colleagues to maximize productivity and impact.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You develop a plan or strategy providing a clear path forward.
I am aware of each employees needs.
I ensure that each team member is assigned some part of the project.
I develop shift patterns or schedules to maximize productivity while addressing individual availability.
I use guiding questions to help employees think critically and make informed decisions.
Innovation	Agree	Unsure	Disagree	N/A
You suggest new ideas at meetings.
You foster a creative and innovative work environment.
You create new and efficient processes.
You offer innovative solutions to Company problems.
I encourage employees to consider opportunities to innovate processes and products.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
You apply appropriate communication techniques to the situation.
You believe honesty and integrity are core tenets of interpersonal relationships.
I give credit where credit is due.
I am willing to overlook personal differences and focus on completing the task at hand.
I promote acceptance of diverse viewpoints from team members.
Responsible	Agree	Unsure	Disagree	N/A
You set high personal standards of performance.
You complete assigned work tasks.
You set a good example.
You take personal responsibility for results.
You are responsible for setting the vision of the department.
Coaching	Agree	Unsure	Disagree	N/A
You are attentive to the needs of employees
You create opportunities for others
You frequently look for opportunities to coach employees.
You help employees to understand responsibilities, authority, and expectations.
You are attentive to the needs of others
Others	Agree	Unsure	Disagree	N/A
You constructively receive criticism and suggestions from others.
You are able to see issues from others' perspectives.
You treat others with respect and dignity.
You treat others with respect and dignity.
You work effectively with people from other departments.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You encourage recognition of diverse perspectives in performance review and goal-setting.
You support and mentor others that may have different cultural backgrounds.
You understand how your own cultural background can impact the way you communicate and interact with others.
You uphold inclusive policies that protect cultural expression and identity in the workplace.
I seek to reduce obstacles in communication that might arise from cultural differences.
Global Perspective	Agree	Unsure	Disagree	N/A
You volunteer for experiences and assignments abroad.
You facilitate open communication with individuals from other countries.
You exemplify the skills of a global worker.
You respect individual differences.
You cooperate with others on a global scale.

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.