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
Does whatever it takes (within reason) to get the job done.
Is not afraid to take corrective action when necessary.
Drives and mobilizes others progress toward goals.
Displays high energy and enthusiasm on consistent basis.
Gets the job done.
Establishing Focus/Direction	Agree	Unsure	Disagree	N/A
Maintains focus when handling several problems or tasks simultaneously.
Maintains self-control when personally criticized.
Makes sure that employees understand and identify with the team's mission.
Functions well under stress, deadlines, and/or significant workloads.
Makes sure that employees understand how their work relates to organizational goals.
Decision Making	Agree	Unsure	Disagree	N/A
Takes into account the impact decisions will have on others.
Makes creative decisions.
Willing to consider information from other sources.
Gathers information before making a decision.
Regularly evaluates information before making important decisions.
Change Management	Agree	Unsure	Disagree	N/A
Supports new initiatives for organizational changes to improve effectiveness.
Effective in dealing with ambiguous and challenging situations.
Able to get department employees to accept new changes.
Effective in implementing new organizational vision and values.
Develops plans for following through on the changes.
Managing Risk	Agree	Unsure	Disagree	N/A
Maintains open communication with other departments.
Implements changes to reduce the chances of critical incidents in the future.
Bases decisions on patterns found in fluid/changing information.
Seeks to increase safety in the workplace.
Performs a risk analysis as needed.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Understands the applicable regulations and laws that impact our business.
Is professional and courteous in interactions with auditors and regulators.
Maintains a state of readiness to address new and changing regulations and procedures.
Follows all safety regulations and procedures.
Empowering Others	Agree	Unsure	Disagree	N/A
Provides support and resources needed to accomplish goals.
Lets employees make their own decisions.
Sets clear goals for others to accomplish.
Is confident in the abilities of employees assigned important tasks.
Allows the employees to have flexible work schedules.
Strategic Focus	Agree	Unsure	Disagree	N/A
Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
Understands & contributes to development of strategic goals.
Able to decline a poor strategy by proposing alternate strategies.
Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
Looks for opportunities to enhance contributions to the bottom line.
Organizational Fluency	Agree	Unsure	Disagree	N/A
Able to explain departmental policies and procedures to others.
Adept at navigating within the culture of the department.
Understands departmental policies and procedures.
Understands the current organizational culture.
Anticipates problems that may affect 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.