Passion to Learn - 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 5 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

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Passion To Learn	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You are open to feedback from others.
You take advantage of training opportunities when they arise.
You enjoy learning new skills and techniques.
You are committed to enhancing your own knowledge and skills.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
If you were to make improvements in Passion To Learn, what are your suggestions for how you can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I utilize feedback in a manner that prioritizes professional development and avoids any misuse.
You ensure that the feedback is relate to the recipient's role and responsibilities.
I am willing to listen and consider feedback from colleagues, supervisors, and other stakeholders.
You conduct seminars on effective communication, offering self-assessment resources, and deploying feedback frameworks.
You plan workshops on effective communication, provide resources for self-assessment, and establish feedback mechanisms.
If you were to make improvements in Feedback, what are your suggestions for how you can improve this?
Creativity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You promote cross-training to broaden creative perspectives and skills.
You add value to the department/organization.
You are creative and inspirational.
I see learning as the engine of creativity, fueling fresh perspectives and novel ideas.
You are able to create innovative products even when under specific constraints and requirements.
If you were to make improvements in Creativity, what are your suggestions for how you can improve this?
Punctuality	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You invoice clients on a timely basis.
You maintain an efficient schedule of activities.
You respond to requests for information in a timely manner.
You arrive to meetings on time.
You conduct appointments at scheduled start time.
If you were to make improvements in Punctuality, what are your suggestions for how you can improve this?
Problem Solving	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You evaluate alternative courses of action.
I ensure that critical aspects of the solution to the problem are well-supported and less likely to encounter issues.
You routinely check and maintain equipment, systems, or processes to catch any signs of wear or inefficiency before they turn into bigger issues.
I conduct ongoing monitoring and follow-up to ensure the solution's continued success and to catch any unintended consequences.
I solicit information about the problem from team members.
If you were to make improvements in Problem Solving, what are your suggestions for how you can improve this?
Clarity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You make sure goals and objectives are clearly and thoroughly explained and understood.
You are clear about goals that need to be achieved.
You write clear job descriptions for positions in the organization.
You make sure employees understand why they were given certain assignments.
You seek to reduce ambiguity in messaging and documents.
If you were to make improvements in Clarity, what are your suggestions for how you can improve this?
Fiscal Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You develop budgets and plans for various programs and initiatives.
You monitor spending.
You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
You develop of the department's annual budget.
You keep excellent records for financial transparency.
If you were to make improvements in Fiscal Management, 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.