Self-Management - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Self:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. Feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences as an employee over the last twelve months and the goals you were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will become part of the assessment process to foster your growth and on-going development.

Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You analyze interpersonal problems instead of reacting to them.
  1. You step away from a situation to process appropriate response.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. You consciously control own negative emotions in order to keep team morale up.
What are your suggestions for how you can make improvements
in Self Management?

Passion To Learn

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You take advantage of training opportunities when they arise.
  1. You embrace new technology and procedures.
  1. You enjoy learning new skills and techniques.
  1. You demonstrate a willingness to participate in continuing education courses.
  1. You take initiative for own learning and development.
What are your suggestions for how you can make improvements
in Passion To Learn?

Establishing Focus/Direction

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You make sure that employees understand and identify with the team's mission.
  1. You make sure that employees understand how their work relates to organizational goals.
  1. You align the department's goals with the goals of the organization.
  1. You are excellent at managing time.
  1. You function well under stress, deadlines, and/or significant workloads.
What are your suggestions for how you can make improvements
in Establishing Focus/Direction?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You analyze data and information from several sources and arrives at logical conclusions.
  1. You implement data validation techniques and methods.
  1. You identify problems and issues needing resolution.
  1. You use appropriate techniques to solve problems.
  1. You identifiy opportunities for progress and innovation.
What are your suggestions for how you can make improvements
in Analytical?

Flexibility

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I adapt to different settings, tasks, and challenges with ease.
  1. You are capable of delivering a diverse range of goods and services to meet various business requirements.
  1. You accommodate adaptable scheduling.
  1. You are capable of adapting workflows to accommodate new regulations or policies.
  1. You respond to issues and problems with creative solutions and innovation.
What are your suggestions for how you can make improvements
in Flexibility?

Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You volunteer your time and effort toward the completion of important goals.
  1. I do things without being told.
  1. When working on a problem in a team, I often am the first to suggest possible solutions.
  1. I seize upon chances to improve the department's prospects.
  1. I initiate draft reports for consideration.
What are your suggestions for how you can make improvements
in Initiative?

Results Oriented

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You help others when free-time is available.
  1. I measure progress toward the goal.
  1. I am always willing to help coworkers to keep productions levels high.
  1. You complete work on time.
  1. I overcome obstacles to continue working toward goals.
What are your suggestions for how you can make improvements
in Results Oriented?

Commitment To Result

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. You encourage commitment in others to obtain results.
  1. You create a sense of urgency among the store team members to complete activities, which drive sales.
  1. You are willing to do whatever it takes-not afraid to have to put in extra effort.
  1. You take immediate action toward goals.
What are your suggestions for how you can make improvements
in Commitment To Result?

Developing Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You support the successes of other employees.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You assign tasks and responsibilities to develop skills of others.
  1. You create opportunities for professional development.
  1. You try to ensure employees are ready to move to the next level.
What are your suggestions for how you can make improvements
in Developing Others?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I am supportive of consensus and power sharing.
  1. I ensure fair treatment for both parties, giving each the chance to speak and share their viewpoints.
  1. You discuss conflict situations with supervisor.
  1. You reframe conflicts as opportunities to innovate and create new solutions to problems.
  1. I promote employee engagement to reduce tensions and negativity, creating an environment where conflicts are easily managed.
What are your suggestions for how you can make improvements
in Conflict Management?

Business Acumen

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand and apply business and financial principles.
  1. You can effectively interpret and analyze market data.
  1. I understand cash flow procedures and statements.
  1. I involve key stakeholders (employees, customers, investors, partners) in the planning process to gain diverse perspectives and buy-in.
  1. You effectively develop and use resources (people, time, money, supplies, equipment, and space) to improve organizational performance
What are your suggestions for how you can make improvements
in Business Acumen?

Entrepreneurship

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You devote a certain amount of time and effort to developing new business opportunities.
  1. You are comfortable operating in an environment of uncertainty.
  1. You balance risks and rewards when making decisions.
  1. You are able to adapt the department to changing business demands and climate.
  1. You encourage dynamic growth opportunities.
What are your suggestions for how you can make improvements
in Entrepreneurship?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.