Problem Solving - 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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Problem Solving	Agree	Unsure	Disagree	N/A
I develop and implement clear guidelines and protocols for handling tasks.
You value the diversity of thought that can uncover unique angles and approaches that might not emerge in a more homogeneous group.
I clearly communicate the action plan to all employees, including team members, management, and other affected parties.
I facilitate rapid development and exchange of ideas.
You collect relevant information and data.
Innovation	Agree	Unsure	Disagree	N/A
You implement best practice methods within the Company.
You maximize the alternative solutions to problems.
You seek innovative ways to change, grow, and improve the department.
You are able to think through complex problems using unique solutions.
You provide the necessary support and resources to empower employees to develop and implement innovative ideas.
Flexibility	Agree	Unsure	Disagree	N/A
I balance multiple perspectives to find common ground and innovative solutions.
I am flexible in effectively handling changes in production volumes.
You scale up production capabilities in response to growing service demands.
You support a flexible culture that values continuous improvement and innovation.
I adapt to different settings, tasks, and challenges with ease.
Passion To Learn	Agree	Unsure	Disagree	N/A
You create an environment that supports personal development and exploration.
You inspire others to learn new things.
You constantly enhance product knowledge through experimentation and play.
You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
You demonstrate a willingness to participate in continuing education courses.
Cultural Awareness	Agree	Unsure	Disagree	N/A
I interact effectively with people from different cultural backgrounds.
You understand what customs and etiquette are important for individuals from other cultures.
You encourage open dialogue and ensure all voices are heard during team discussions.
I seek out opportunities to learn about different cultures and integrate that knowledge into leadership practices.
I create safe spaces for employees to share cultural perspectives and experiences.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You lead by example to guide employees in the completion of tasks.
You seek to enhance your understanding of the department's dynamics to better determine the needs of the department.
You regularly check in to ensure the team is on track.
I plan responses to potential risks or unforeseen challenges to minimize disruption.
You understand the strengths and need of the team.
Administrative Skill	Agree	Unsure	Disagree	N/A
I display a professional presence when interacting with others.
You identify complex problems and review related information to develop and evaluate options and implement solutions.
You plan, develop, and deliver presentations.
I maintain appropriate levels of supplies and re-order supplies as needed.
You manage documents effectively by organizing, storing, and retrieving physical and digital files efficiently.
Commitment	Agree	Unsure	Disagree	N/A
You model transparency in commitment, showing that ownership of a task means being answerable for both successes and setbacks.
You are committed to the process put in place even though the results are not immediately seen.
You strive to increase commitment from coworkers for the department's initiatives.
I foster commitment among employees to leverage their talents for collective success of the department.
I cultivate employee dedication to organizational goals and outcomes.
Objectives	Agree	Unsure	Disagree	N/A
You effectively organize resources and plans
You assure [Company] principles are understood, employed & pursued.
You organize and schedules events, activities, and resources.
You encourage others to take on greater responsibility.
You are able to organize work.
Responsible	Agree	Unsure	Disagree	N/A
Your behavior is ethical and honest.
You are responsible for setting the vision of the department.
You complete assigned work tasks.
You take personal responsibility for results.
You set a good example.
Co-worker Development	Agree	Unsure	Disagree	N/A
You provide ongoing feedback to co-workers on your development progress
You take immediate action on poor performance
You adapt coaching and mentoring approach to meet the style or needs of individuals
You set and clearly communicate expectations, performance goals, and measurements to others
You work to identify root causes of performance problems
Strategic Insight	Agree	Unsure	Disagree	N/A
You adjust strategic plans based on insights gathered from different points of view.
You understand how to strategically grow the business and increase customers.
You keep abreast of regulatory, technological, and competitive shifts that could impact the organization's strategic direction.
You strategically align projects to the goals of the company.
I translate complex industry trends into actionable strategies for the team/department.

61. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.