360 Feedback Survey Example 1

Rater:

You are providing feedback to:

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. 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 months. Your responses will be merged with other's feedback and presented to the manager to guide them in their on-going development. Comments will be shared anonymously as written with the manager, unless you indicate otherwise.

Method of use: As part of the annual appraisal process, leaders receive feedback from peers, subordinates, customers and supervisors. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the individual's annual appraisal and development plan.

To what extent does ____________ exhibit the following ...

Rater:
You are providing feedback to:

Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, direct reports and/or others will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

Accountability	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Acts like an owner when they make decisions.
Can be counted on to do what they say they are going to do.
Defines roles, rights, and responsibilities of employees
Tackles issues head on and finds solutions.
Takes responsibility for results.
Takes ownership of mistakes and learns from them.
Is someone you can trust.
Is someone who is there when you need them.
Encourages employees to take on greater responsibilities
Informs supervisor of progress without having to be asked about it
Do you have any additional comments about this individual's Accountability? If so, please explain.
Communication Style	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Presents issues, ideas, and strategy concisely and clearly.
Encourages Open Communication
Conveys priorities with right sense of urgency and importance.
Deals with difficult situations calmly and confidently
Conveys ideas confidently and succinctly.
Delivers difficult messages to co-workers in an appropriate manner
Considers the audience in how the communication is presented.
Do you have any additional comments about this individual's Communication Style? If so, please explain.
Interpersonal Skills	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Takes time to listen to you
Relates to all kinds of people tactfully, from shop floor to executives
Listens actively & speaks clearly and directly.
Is visible and approachable
An effective listener who is responsive to information needs
Conducts regular performance feedback discussions with individuals and teams
Accurately attends to/understands ideas which are exchanged.
Do you have any additional comments about this individual's Interpersonal Skills? If so, please explain.
Impact	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Communicates the vision of the organization to all employees
Informs others about changes or developments in plans and goals
Explains reasons behind decisions and actions
Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
Inspires others to take action based on his/her communications
Reviews any "action steps" resulting from meetings or conversations before concluding to ensure clarity and that plans will be executed
Do you have any additional comments about this individual's Impact? If so, please explain.
Situational Awareness	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Accepts the views of others.
Actively seeks feedback from others.
Asks others for their ideas and opinions.
Is easy to approach with ideas and opinions
Looks to others for input
Seeks and utilizes data from several sources.
Seeks feedback to enhance performance.
Do you have any additional comments about this individual's Situational Awareness? If so, please explain.
Business Acumen	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Is goal-directed, persistent, and driven to achieve objectives (sets direction)
Identifies and pursues resources needed to improve performance (allocate resources)
Understands and applies ethical business and financial principles
Accurately evaluates the implications of new information or events
Views problems from a business perspective, opportunity, investment, risks and anticipated results
Effects outcomes that set high standards for others
Do you have any additional comments about this individual's Business Acumen? If so, please explain.
Leading Others	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Maximizes the efforts of all team members
Able to organize the work of others
Aligns manpower, designs work, and allocates tasks to achieve goals.
Uses persuasion and influence instead of micromanaging employees
Empowers others to achieve results and holds them accountable for actions.
Motivates others to reach and exceed organizational goals and objectives.
Inspires a shared vision of being the best
Do you have any additional comments about this individual's ability to Lead Others? If so, please explain.
Leading by Example	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Critiques own performance as a means of self-improvement and initiates self-development activities
Takes ownership and accountability for results
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Acts decisively in implementing decisions
Encourages and is receptive to working out problems and challenges --- no reluctance from team members to come forward with concerns/issues.
Supports Company sponsored training and development initiatives.
Implements decision and evaluates results.
Do you have any additional comments about this individual's ability to Lead by Example? If so, please explain.
Problem Solving	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Ability to solve problems at root cause rather than at symptom level
Develops innovative solutions to problems
Analyzes alternatives and selects a course of action.
Assumes new and difficult challenges and manages them as opportunities.
Collects relevant information and data.
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Implements solutions and evaluates results.
Makes judgments based upon relevant information.
Analyzes systems and processes for opportunities to gain efficiency.
Is aware of problems or issues that may affect the organization
Looks for opportunities to enhance contributions to the bottom line
Do you have any additional comments about this individual's Problem Solving skills? If so, please explain.
Is a Team Player	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Demonstrates compassion and respect for others through actions; is concerned about their work and non-work issues
Is open to new ideas that may change own goals for benefit of the team
Comes across as a reliable, committed team member
Helps other managers in need of assistance, such as providing needed resources (co-workers, supplies, etc.)
Partners with people from other work units to improve overall performance
Contributes to and supports team decision-making process
Is open to the suggestions of others when working on a problem
Facilitates team discussions and problem-solving
Do you have any additional comments about whether this individual's Is a Team Player? If so, please explain.
Promotes Teamwork	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Fosters teamwork rather than individual competition
Promotes open participation and communication within department and throughout the organization.
Creates a culture that fosters and values collaboration
Creates a climate that encourages team participation
Ensures that the right people are on the team in the appropriate roles, including who should be team leader for a particular project/situation.
Facilitates conflict resolution discussions between individuals in different teams
Creates and implements team reward and recognition programs
Creates opportunities to learn with other team members
Do you have any additional comments about this individual's ability to Promote Teamwork? If so, please explain.
Professional Presence	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Develops a reputation as a "go-to" resource sought out by others
Gains commitment by persuading, not by demanding
Commands the attention of an audience of one or many
Remains focused on guiding others towards most important objectives (ensure execution)
Creates a professional image that establishes and maintains credibility
Establishes influential contacts both inside and outside the company
Do you have any additional comments about this individual's Professional Presence? If so, please explain.

Strengths:


Opportunities for Development: