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
Strives to exceed standards of performance.
Accepts setbacks and challenges as improvement opportunities
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Establishes stretch goals to advance skills and output.
Follows-up and takes action when goals are not met to ensure better results in the future.
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.
Keeps themselves and others focused on constant improvement.
Demonstrates the analytical skills to do their job.
Is planful and organized.
Takes a lot of pride in their work.
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.
Demonstrates a sense of responsibility and commitment to public trust.
Takes care to maintain confidential information.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Is trustworthy; is someone I can 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
Steps away from a situation to process appropriate response.
Analyzes interpersonal problems instead of reacting to them.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
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
Supports the successes of other employees.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Encourages employees through recognition of positive changes in behavior.
Sets performance objectives for subordinates that encourages development opportunities.
Is open to receiving feedback.
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
Ensures others follow the correct rules and regulations on fiscal matters.
Monitors expenses and verifies the need for items purchased.
Provides budgeting and accounting support to the Company.
Develops of the department's annual budget.
Monitors spending.
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.