Achievement - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

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. 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 '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 (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 .

Achievement	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Completes work to a high technical standard
Takes calculated risks to achieve higher levels of performance.
Increased customer satisfaction scores for the quarter.
Improved the quality of work on the production line.
Inspires others to work with a sense of urgency.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Excellence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Produces high quality work.
Can be counted on to add value wherever they are involved.
Takes a lot of pride in their work.
Is planful and organized.
Demonstrates the functional or technical skills necessary to do their job.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Takes ownership, delivers on commitments
Takes care to maintain confidential information.
Builds and maintains the trust of others.
Delivers on promises made.
Demonstrates a sense of responsibility and commitment to public trust.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Analyzes interpersonal problems instead of reacting to them.
Consciously controls own negative emotions in order to keep team morale up.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Uses patience and self-control in working with customers and associates.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Creates a work environment that fosters positive feedback to employees.
Supports the successes of other employees.
Encourages employees through recognition of positive changes in behavior.
Recognizes and celebrates accomplishments of others.
Creates opportunities for professional development.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?
Fiscal Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Provides budgeting and accounting support to the Company.
Keeps excellent records for financial transparency.
Monitors spending.
Monitors expenses and verifies the need for items purchased.
Develops of the department's annual budget.
If [Participant Name] were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

31. Strengths
    
    
    
32. Areas for Development
    
    
    
33. Please give any final comments or suggestions for [Participant Name Here]'s assessment.