Quality - 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 .

Quality	Agree	Unsure	Disagree	N/A
You analyze what occurred and re-adjusts accordingly when goals are not met.
You encourage others to achieve high quality standards.
You always strive to produce the highest quality work products.
You hold employees accountable for your quality of work.
You encourage others to produce the highest quality work products.
Initiative	Agree	Unsure	Disagree	N/A
I take on additional tasks without being asked or told to do so.
You are an inspiration for others to perform above expectations.
You go above and beyond the stated goals.
You are a self-starter. You do not wait to be told to do something.
You volunteer your time and effort toward the completion of important goals.
Commitment To Result	Agree	Unsure	Disagree	N/A
You are able to focus on a task even when working alone.
You create a sense of urgency among the store team members to complete activities, which drive sales.
You take immediate action toward goals.
You are committed to the team.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
Clarity	Agree	Unsure	Disagree	N/A
You make sure employees understand why they were given certain assignments.
You attend to the important details of a job or task.
You avoid stating unclear or conflicting goals.
You avoid creating ambiguity or mixed messages.
You provide a clear vision for the future.
Managing Risk	Agree	Unsure	Disagree	N/A
You develop policies for risk management.
You attend risk management seminars and conferences.
You are aware of process safety management.
You know how to obtain desired results with minimal losses.
You develop policies to address risk situations in the workplace.
Attitude	Agree	Unsure	Disagree	N/A
You visibly support and encourages diversity in style and background.
You work to eliminate unnecessary work or barriers that get in others' way.
You contribute to a positive work environment.
You are gracious and professional in your interactions with others.
You contribute to a positive and fun work environment.
Supervisory Skills	Agree	Unsure	Disagree	N/A
I exemplify professionalism in the workplace.
I am effective in using rewards to help motivate employees.
I lead others through my commitment to the department.
I am effective in resolving conflicts to mutual satisfaction of the parties.
You delegate effectively.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You are excellent at managing relationships with stakeholders.
You find unique ways to go around barriers to success.
You are able to adapt the department to changing business demands and climate.
You seek and utilize mentors to help guide your professional development.
You devote a certain amount of time and effort to developing new business opportunities.
Vision	Agree	Unsure	Disagree	N/A
You demonstrate consistency between words and actions
You lead employees in new directions.
You behave in a way that is consistent with business values & code of conduct
You create a positive vision of the future for the Company.
You express the Company vision in a way that is easily understood and adopted by employees.

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

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.