Technical Skills - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Self-Assessment Form Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. All Leadership Team Members will be participating at this time.

In this regard, you need to complete a self-assessment questionnaire form (below).
Your responses will be combined with the responses from your peers and direct reports. 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.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Technical	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You seek information from others as needed.
You willingly share your technical 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 willingly share information and expertise; sought out as resource by others
If you were to make improvements in Technical, what are your suggestions for how you can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You analyze interpersonal problems instead of reacting to them.
You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
You consciously control own negative emotions in order to keep team morale up.
You do not allow own emotions to interfere with the performance of others.
You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
If you were to make improvements in Self Management, what are your suggestions for how you can improve this?
Managing Risk	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You seek to increase safety in the workplace.
You avoid maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
You track risks in a project.
You create informative guides regarding potential risks and risky behaviors.
You offer training to reduce safety incidents in the workplace.
If you were to make improvements in Managing Risk, what are your suggestions for how you can improve this?
Client Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I am competent in managing client projects.
You are honest in all communication with the clients.
You form strong client relationships
You thoroughly understand the needs of the client.
You provide excellent service to clients.
If you were to make improvements in Client Focus, what are your suggestions for how you can improve this?
Recognition	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You recognize team members who offer a significant contribution to a project.
You reinforce and reward employees for accomplishing necessary goals.
You are sincerely interested in the suggestions of co-workers
You recognize individuals for a specific outstanding achievement.
You let employees know when they have done well
If you were to make improvements in Recognition, what are your suggestions for how you can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
You understand how decisions impact other business units beyond your immediate department of work group.
You understand the "basics" as to how [Company] functions/operates.
You understand the use of [Company] products and services.
You express loyalty and dedication to [Company] in interactions with others.
You follow existing procedures and processes.
If you were to make improvements in Company, what are your suggestions for how you can improve this?
Planning	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
I conduct regular assessments of the project status to ensure adherence to the set schedule.
I schedule staff based on seasonal needs.
I can effectively use logistics planning to reduce supply delays.
You are able to closely follow the plan established for the department.
You anticipate resources needed to successfully implement a plan or project.
If you were to make improvements in Planning, what are your suggestions for how you can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for [Participant Name Here]'s assessment.