Action - 360 Degree Feedback Survey Sample #1

Instructions:

The is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between and . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Action	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Gets the job done.
Motivates & supports others to gain skills
Makes effective decisions, even when under pressure.
Drives and mobilizes others progress toward goals.
Displays high energy and enthusiasm on consistent basis.
If were to make improvements in Action, what are your suggestions for how he/she can improve this?
Continual Learning	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Pursues self-improvement through continual learning.
Builds on their strengths while addressing their weaknesses.
Grasps new ideas, concepts, technical, or business knowledge.
Sets relevant learning objectives and goals.
Shares best practices with others and learns from others.
If were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?
Leadership	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
Gives direct, constructive, and actionable feedback.
Highly effective supervisor.
Acts decisively in implementing decisions.
Able to influence others.
If were to make improvements in Leadership, what are your suggestions for how he/she can improve this?
Delegation	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Defines the roles, responsibilities, required actions, and deadlines for team members.
Sets clear and reasonable expectations for others and follows through on their progress.
Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
If were to make improvements in Delegation, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Recognizes and implements changes to enhance efficiency and effectiveness.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Able to work effectively with new people and new teams.
Learns from personal experiences and/or mistakes.
Works effectively in dynamic and changing work environments.
If were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
Assesses current capabilities before committing to new requests from customers.
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Can multi-task while performing all of their other responsibilities and activities.
If were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Interpersonal Skills	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Adapts management style to meet the needs of the individual or situation.
Values the opinions of others.
Is open and approachable
Uses tact, compassion, and sensitivity in interactions with others.
Successfully resolves conflicts and grievances to a win-win solution.
If were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?
Co-worker Development	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
If were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?
Others	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Works across boundaries within the organization.
Respects the opinions of other employees.
Treats others with respect and dignity.
Supports the efforts of other employees in implementing solutions to problems.
Forms working relationships with employees from other departments.
If were to make improvements in Others, what are your suggestions for how he/she can improve this?
Entrepreneurship	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Devotes a certain amount of time and effort to developing new business opportunities.
Exhibits determination and passion in completion of goals.
Encourages risk taking for developing potential business opportunities.
Able to adapt the department to changing business demands and climate.
Has a strategic awareness on how to promote the organization.
If were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

50. What are 's greatest strengths demonstrated this year?
    
    
    
51. What are 's areas for development?
    
    
    
52. Please give any final comments or suggestions for 's assessment.