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 develop measures of the success of quality initiatives.
I verify the correct materials were used in the installation.
You encourage others to achieve high quality standards.
You analyze quality improvement plans and initiatives.
You present quality information and data in an easy to understand format.
Initiative	Agree	Unsure	Disagree	N/A
I take action to implement new changes in the policies and procedures.
You take the initiative to complete tasks ahead of schedule.
You coach others to foster an environment which can adapt quickly and willingly to rapid change.
You seek and utilize opportunities for continuous learning and self-development.
You take the initiative to change the direction or course of events.
Commitment To Result	Agree	Unsure	Disagree	N/A
You create a sense of urgency among the store team members to complete activities, which drive sales.
You are able to focus on a task even when working alone.
You are committed to the team.
You are willing to do whatever it takes-not afraid to have to put in extra effort.
You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Clarity	Agree	Unsure	Disagree	N/A
You clearly explains responsibilities to individuals.
You make sure employees understand why they were given certain assignments.
You adjust communication methods to the needs of the audience.
You maintain clarity in goals and objectives.
You make sure goals and objectives are clearly and thoroughly explained and understood.
Managing Risk	Agree	Unsure	Disagree	N/A
You seek to maintain the long-term viability of the Company through effective risk management.
You develop policies to address risk situations in the workplace.
You track risks in a project.
I seek specific risks that will create opportunities to advance the department/company.
You implement changes to reduce the chances of critical incidents in the future.
Attitude	Agree	Unsure	Disagree	N/A
You contribute to a positive and fun work environment.
You build open and trusting relationships.
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.
Supervisory Skills	Agree	Unsure	Disagree	N/A
You complete assessments in a timely manner.
I coach subordinates in how to make good decisions.
You ensure employees know what they need to complete during the shift.
I foster a culture of personal responsibility and accountability.
You are respectful toward employees.
Entrepreneurship	Agree	Unsure	Disagree	N/A
You encourage dynamic growth opportunities.
You are able to adapt the department to changing business demands and climate.
You encourage risk taking for developing potential business opportunities.
You understand the processes and various stages of business development.
You seek and utilize mentors to help guide your professional development.
Vision	Agree	Unsure	Disagree	N/A
You commit to undertaking the implementation of the strategic vision.
You diagnose issues and envision solutions.
You cultivate an environment that embodies the department's vision.
I develop a strategic vision informed by comprehensive analysis of the company's performance.
You ensure that work is systematically aligned and coordinated with the organization's vision.

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.