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 high personal standards of performance.
You are a person others can trust.
You complete assigned work tasks.
You are responsible for setting the vision of the department.
You act as a resource without removing individual responsibility.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You define the roles, responsibilities, required actions, and deadlines for team members.
You encourage and empower subordinates to use initiative in achieving goals and objectives.
You entrust subordinates with important tasks.
You set clear and reasonable expectations for others and follow through on their progress.
You clearly define duties and tasks to be completed.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I am receptive to new ideas from others when making decisions.
I formulate imaginative decisions.
I evaluate information before making a final decision.
You break complex issues into manageable parts and organize them in a systematic way before making decisions
I make good decisions for the Department.
Empowering Others	Definite Strength	Meets Standards	Needs Development	N/A
You set clear goals for assignments.
I assign tasks that allow employees to use their critical thinking skills.
You support the decisions of others.
You encourage others to obtain necessary skills and training.
You create opportunities for employees to exercise their independence.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You carry your share of the workload
I build a strong rapport with team members.
You are able to adjust to changes in the composition of the team.
I make decisions that support the team's goals and objectives.
You build relationships across boundaries and with key stakeholders by developing informal and formal networks.
Creativity	Definite Strength	Meets Standards	Needs Development	N/A
You conceive, implement and evaluate ideas.
You develop solutions to challenging problems.
You create a lot of new ideas.
You are creative and inspirational.
You are creative.
Punctuality	Definite Strength	Meets Standards	Needs Development	N/A
You maintain an efficient schedule of activities.
You start meetings on time.
You conduct appointments at scheduled start time.
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 willingly share information and expertise; sought out as resource by others
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 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 your technical expertise; sought out as resource by others
Clarity	Definite Strength	Meets Standards	Needs Development	N/A
You make sure goals and objectives are clearly and thoroughly explained and understood.
You communicate ideas and facts clearly and effectively in writing.
You are clear about the roles and duties of team members.
You clearly explain the vision and goals of the company.
You avoid creating ambiguity or mixed messages.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You are able to deal with sensitive issues with tact and professionalism.
You are effective in communicating with others within the organization.
You understand the current organizational culture.
You are able to explain departmental policies and procedures to others.
You get things done through 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.