Action - 360 Degree Feedback Survey Sample #8

Instructions

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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Action	Agree	Unsure	Disagree	N/A
Prepares equipment at the start of the shift.
Looks for extra ways to help the department achieve performance goals.
Moves forward on important projects.
Anticipates needs and takes pre-emptive action to address the issue.
Immediately develops alternatives and solutions when presented with a problem or issue.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
Functions well under stress, deadlines, and/or significant workloads.
Makes sure that employees understand how their work relates to organizational goals.
Maintains focus when handling several problems or tasks simultaneously.
Sets appropriate goals for employees.
Makes sure that employees understand and identify with the team's mission.
Decision Making	Agree	Unsure	Disagree	N/A
Exercises good judgment by making sound and informed decisions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Weighs the pros and cons of decisions.
Examines relevant factors needed to make a decision.
Determines the costs and potential benefits of decisions.
Change Management	Agree	Unsure	Disagree	N/A
Works cooperatively with others to implement changes.
Supports the Company's efforts to implement changes.
Addresses organizational and departmental resistance to changes.
Inspires others to accept changes.
Is a leading force driving changes.
Managing Risk	Agree	Unsure	Disagree	N/A
Uses risk management to ensure smooth operations.
Is concerned about process safety management.
Determines the impact of specific risks on infrastructure.
Determines a proportional response in relation to the level of risk.
Recognizes that small changes may snowball into major events.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Understands the applicable regulations and laws that impact our business.
Develops a confidential reporting system to enable employees to anonymously report safety violations.
Effectively communicates the importance of meeting compliance standards.
Ensures the company meets legal requirements/standards regarding employees.
Follows up on any unresolved compliance issues.
Empowering Others	Agree	Unsure	Disagree	N/A
Recognizes the importance of a healthy work/life balance.
Supports the decisions of others.
Assigns tasks that allow employees to use their critical thinking skills.
Gives employees the freedom to set their own schedule.
Is confident in the abilities of employees assigned important tasks.
Strategic Focus	Agree	Unsure	Disagree	N/A
Creates a strategy to achieve departmental objectives.
Aligns projects to the strategic goals of the company.
Creates a vision for the organization based on how the organization should appear in the future.
Undertakes a SWOT analysis to determine the best strategy to move forward.
Develops high-level strategic planning models to identify opportunities to improve the company.
Organizational Fluency	Agree	Unsure	Disagree	N/A
Able to explain departmental policies and procedures to others.
Able to use corporate politics to advance department objectives.
Adept at navigating within the culture of the department.
Anticipates problems that may affect the department.
Gets things done through the department.

46. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.