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
Demonstrates a well-organized and timely approach to achieve desired results
Takes immediate action of projects that fall behind schedule.
Driven to complete goals despite obstacles that may arise.
Completes work promptly and efficiently.
Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.
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
Demonstrates the functional or technical skills necessary to do their job.
Takes a lot of pride in their work.
Is planful and organized.
Produces high quality work.
Demonstrates the analytical skills 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
Builds and maintains the trust of others.
Consistently keeps commitments.
Delivers on promises made.
Works in a way that makes others want to work with her/him.
Takes care to maintain confidential information.
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
Uses patience and self-control in working with customers and associates.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
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
Is open to receiving feedback.
Creates a work environment that fosters positive feedback to employees.
Recognizes and celebrates accomplishments of others.
Tries to ensure employees are ready to move to the next level.
Sets performance objectives for subordinates that encourages development opportunities.
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
Monitors expenses and verifies the need for items purchased.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Ensures others follow the correct rules and regulations on fiscal matters.
Develops budgets and plans for various programs and initiatives.
Provides budgeting and accounting support to the Company.
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.