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 set a good example
You act as a resource without removing individual responsibility.
You are a person others can trust.
You take personal responsibility for results.
You set high personal standards of performance.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You clearly define duties and tasks to be completed.
You assign tasks to create learning opportunities for the employees.
You allow employees to decide how they wish to complete the tasks.
You set clear and reasonable expectations for others and follow through on their progress.
You allow subordinates to use their own methods and procedures.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
You ask for additional information when making critical decisions.
You maintain focus on the "big picture" when making decisions.
I regularly evaluate information before making important decisions.
I define the parameters that will impact the decision making process.
I facilitate meetings with others to try to consider alternative courses of action.
Empowering Others	Definite Strength	Meets Standards	Needs Development	N/A
I give new tasks to employees.
You express confidence in the abilities of others.
You distribute the workload to subordinates.
I encourage employees to take on greater responsibilities.
I include others in the decision making process.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You act as an effective team player
You relate to all kinds of people tactfully
You help the team decide what long term goals need to be met.
I help the team to bounce back from obstacles.
You promote open communication on the team.
Creativity	Definite Strength	Meets Standards	Needs Development	N/A
You add value to the department/organization.
You create a lot of new ideas.
You develop solutions to challenging problems.
You are creative and inspirational.
You inspire creativity in your team.
Punctuality	Definite Strength	Meets Standards	Needs Development	N/A
You start the workday when scheduled.
You conduct appointments at scheduled start time.
You invoice clients on a timely basis.
You maintain an efficient schedule of activities.
You arrive to meetings on time.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You seek information from others as needed.
You willingly share your technical expertise; sought out as resource by others
You are knowledgeable of procedures or systems necessary for the job.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You communicate with clarity and efficiency.
You make sure employees understand why they were given certain assignments.
You write clear job descriptions for positions in the organization.
You attend to the important details of a job or task.
You are clear about goals that need to be achieved.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You are effective in communicating with others within the organization.
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.
You understand the current organizational culture.
You are adept at navigating within the culture of the department.

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.