Action - 360 Degree Feedback Survey Sample #2

Instructions

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 and the goals they were asked to achieve. 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 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.

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

Action	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Does whatever it takes (within reason) to get the job done.
Gets the job done.
Works quickly when faced with difficult problems.
Is not afraid to take corrective action when necessary.
Drives and mobilizes others progress toward goals.
What are your suggestions for how can make improvements in Action?
Punctuality	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Arrives to meetings on time.
Maintains an efficient schedule of activities.
Starts meetings on time.
Conducts appointments at scheduled start time.
Responds to requests for information in a timely manner.
What are your suggestions for how can make improvements in Punctuality?
Attitude	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Shows by their actions that they trust in the positive intentions of others.
Works to eliminate unnecessary work or barriers that get in others' way.
Visibly supports and encourages diversity in style and background.
Builds open and trusting relationships.
Contributes to a positive and fun work environment.
What are your suggestions for how can make improvements in Attitude?
Management	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Is ready to offer help
Sets an example for others to follow
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Takes responsibility for things that go wrong
What are your suggestions for how can make improvements in Management?
Commitment To Result	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Committed to the team.
Able to focus on a task even when working alone.
Maintains persistence and dedication to achieving results.
Coordinates all department activities into a cohesive team effort.
Takes immediate action toward goals.
What are your suggestions for how can make improvements in Commitment To Result?
Technical	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Demonstrates mastery of the technical competencies required in his/her work.
Knows how to produce high quality products/work.
Willingly shares information and expertise; sought out as resource by others
Is knowledgeable of procedures or systems necessary for the job.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
What are your suggestions for how can make improvements in Technical?
Trustworthy	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Consistently keeps commitments.
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Demonstrates a sense of responsibility and commitment to public trust.
What are your suggestions for how can make improvements in Trustworthy?
Conflict Management	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Identifies and takes steps to prevent potential confrontations.
Discusses conflict situations with supervisor.
Helps employees to think through alternative ways to resolve conflict situations.
Clearly expresses expectations to others.
Tries to understand others' point of view before making judgments
What are your suggestions for how can make improvements in Conflict Management?
Teamwork	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Facilitates team discussions and problem-solving
Creates a climate that encourages team participation.
Creates opportunities to learn with other team members
Shares credit for accomplishments with team members
Encourages collaboration with other departments.
What are your suggestions for how can make improvements in Teamwork?
Vision	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Understands the vision of the Company and promotes it ahead of any self-interests.
Leads employees in new directions.
Demonstrates consistency between words and actions
Persuades others to follow the Company's vision.
Expresses the Company vision in a way that is easily understood and adopted by employees.
What are your suggestions for how can make improvements in Vision?

51. Strengths
    
    
    
52. Areas for Development
    
    
    
53. Please give any final comments or suggestions for 's assessment.