Accountability - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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 .

Accountability	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Works to achieve established goals.
Takes charge of addressing and solving problems.
Always keeps the supervisor informed of relevant information.
Accepts responsibility to lead efforts to solving critical problems.
Takes personal responsibility for the quality of their work.
Acts like an owner when they make decisions.
Makes sure the supervisor is always informed of any important events.
Acknowledges errors and takes the steps necessary to rectify them.
Encourages employees to take on greater responsibilities.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Passion To Learn	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Demonstrates through personal behavior the commitment to high standards of performance.
Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
Enjoys learning new skills and techniques.
Holds self and associates accountable for goal achievement.
Is committed to enhancing their own knowledge and skills.
Takes initiative for own learning and development.
Creates an environment that supports personal development and exploration.
Embraces new technology and procedures.
Constantly enhances product knowledge through experimentation and play.
If [Participant Name] were to make improvements in Passion To Learn, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Is easy to approach with ideas and opinions.
Shares past experiences with others as learning opportunities.
Open to the suggestions of others.
Asks others for their ideas and opinions.
Is visible and approachable.
Actively seeks feedback from others.
Considers other's opinion and suggestions.
Seeks feedback to enhance performance.
Accepts the views of others.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Performance	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Effective in performing his/her job.
Sets a high standard for job performance.
Works well in this position.
Effectively organizes resources and plans
Listens and responds to issues and problems
...Overall Performance
Has great overall performance
Works effectively in the department.
Shown significant improvement in job performance.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Ensures that assignments are prioritized according to the needs of the department/company.
Coordinates the work of a team by assigning tasks to other team members.
Keeps track of multiple assignments and deadlines.
Begins tasks as soon as possible.
Switches attention to more urgent tasks when necessary.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Uses a scheduler/planner to keep tasks organized and on time.
Determines which tasks are critical and which tasks are optional.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Values others in decision making.
Develops networks and builds alliances with employees throughout the company.
Respects and utilizes diverse perspectives in addressing challenges.
Works with others to resolve issues facing the company.
Creates a culture that encourages understanding and valuing diverse perspectives to effectively resolve conflicts.
Committed to fostering a collaborative work environment in the department.
Encourages collaboration with other departments.
Fosters a cooperative environment rather than a highly competitive one.
Views others as valued partners.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Responsible	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Acts as a resource without removing individual responsibility.
Sets high personal standards of performance.
...takes personal responsibility for results.
Behavior is ethical and honest.
Sets a good example
Completes assigned work tasks.
Is a person you can trust.
Holds herself / himself accountable to goals / objectives
Responsible for setting the vision of the department.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

64. Strengths
    
    
    
65. Areas for Development
    
    
    
66. Please give any final comments or suggestions for [Participant Name Here]'s assessment.