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.



Please complete your response by .

Problem Solving	Agree	Unsure	Disagree	N/A
You are effective in solving problems.
You find creative ways to get things done with limited resources.
You actively seek the root cause of a problem.
You identify and assess all potential responses to a problem.
You identify fresh approaches and shows a willingness to question traditional assumptions.
Innovation	Agree	Unsure	Disagree	N/A
You find creative ways to get things done with limited resources.
You take risks to advance important ideas.
You search for opportunities and innovative ways to improve the organization.
You challenge current procedures to develop other alternatives.
You build upon the ideas and solutions of others.
Flexibility	Agree	Unsure	Disagree	N/A
I am agile and versatile when responding to critical issues.
I encourage open communication and collaboration, allowing everyone to contribute their ideas and perspectives.
You adapt to circumstances as needed.
I continuously learn and adapt new techniques to address evolving challenges.
You are able to adapt to new situations.
Passion To Learn	Agree	Unsure	Disagree	N/A
You enjoy learning new skills and techniques.
You are open to feedback from others.
You stay up-to-date on emerging technologies.
You hold self and associates accountable for goal achievement.
You take initiative for own learning and development.
Cultural Awareness	Agree	Unsure	Disagree	N/A
You acknowledge your own biases in cultural interactions.
I am effective in working with individuals with a variety of cultural backgrounds.
I am aware of my cultural views.
You understand the impact that your culture may have on interactions between individuals.
You accept individual differences.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
You help guide employees with prioritizing tasks.
You are excellent at managing time.
You maintain self-control when personally criticized.
You set appropriate goals for employees.
You function well under stress, deadlines, and/or significant workloads.
Administrative Skill	Agree	Unsure	Disagree	N/A
You have strong technical/computer skills.
You implement and use performance measures.
You have a high attention to detail.
You take responsibility for decisions.
You are able to develop, justify and present a budget.
Commitment To Result	Agree	Unsure	Disagree	N/A
You are able to focus on a task even when working alone.
You maintain persistence and dedication to achieving results.
You encourage commitment in others to obtain results.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
You are committed to the team.
Objectives	Agree	Unsure	Disagree	N/A
You work toward achieving established goals and objectives.
You organize and schedules events, activities, and resources.
You consistently provide me with timely feedback for improving my performance.
You effectively organize resources and plans
You establish goals and objectives.
Responsible	Agree	Unsure	Disagree	N/A
You are a person others can trust.
You set a good example.
You set high personal standards of performance.
You hold yourself accountable to goals / objectives
You work in a way that makes others want to work with you.
Co-worker Development	Agree	Unsure	Disagree	N/A
You adapt coaching and mentoring approach to meet the style or needs of individuals
You take immediate action on poor performance
You provide ongoing feedback to co-workers on your development progress
You give others development opportunities through project assignments and increased job responsibilities
You work to identify root causes of performance problems
Strategic Insight	Agree	Unsure	Disagree	N/A
You create strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
You let employees know how their roles contribute toward the achievement of strategic company objectives.
You ommunicate with employees to find out their needs.
I create a vision for the organization based on insights gathered from other companies in the industry.
You create strategies that significantly benefit the Company.

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.