Responsibility - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to you at the next leadership seminar to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Responsible	Definite Strength	Meets Standards	Needs Development	N/A
You work in a way that makes others want to work with you.
You hold yourself accountable to goals / objectives
You complete assigned work tasks.
You set high personal standards of performance.
You take personal responsibility for results.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
You allow subordinates to use their own methods and procedures.
You delegate authority and responsibility to subordinates and holds them accountable for your actions.
You assign tasks to create learning opportunities for the employees.
You allow employees to decide how they wish to complete the tasks.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
You are open to the suggestions from subordinates.
I examine for patterns in data to help predict future possibilities.
I formulate imaginative decisions.
You examine relevant factors needed to make a decision.
I am open to listening to others who may have different ideas.
Empowering Others	Definite Strength	Meets Standards	Needs Development	N/A
You give employees autonomy to complete tasks on their own.
You give employees input into the decision making process.
You are confident in the abilities of employees assigned important tasks.
You ensure employees understand what is being assigned to them.
You give responsibility for making important decisions to employees.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You encourage teamwork and collaboration.
You carry your share of the workload
You relate to all kinds of people tactfully
You encourage others to share ideas to develop team cohesion
You work cooperatively with others to solve problems.
Creativity	Definite Strength	Meets Standards	Needs Development	N/A
You are creative and inspirational.
You create a lot of new ideas.
You inspire creativity in your team.
You develop solutions to challenging problems.
You conceive, implement and evaluate ideas.
Punctuality	Definite Strength	Meets Standards	Needs Development	N/A
You conduct appointments at scheduled start time.
You avoid making personal phone calls during working hours.
You invoice clients on a timely basis.
You respond to requests for information in a timely manner.
You start the workday when scheduled.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You seek information from others as needed.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You are knowledgeable of procedures or systems necessary for the job.
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You willingly share information and expertise; sought out as resource by others
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You make sure employees understand why they were given certain assignments.
You avoid creating ambiguity or mixed messages.
You write clear job descriptions for positions in the organization.
You clearly explains responsibilities to individuals.
You adjust communication methods to the needs of the audience.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You anticipate problems that may affect the department.
You are effective in communicating with others within the organization.
You are able to explain departmental policies and procedures to others.
You are aware of other organizational cultures to compare/contrast with the current organizational culture.
You are able to deal with sensitive issues with tact and professionalism.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.