Adaptability - 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 .

Adaptability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to quickly learn new ways of performing their job.
Flexible and open to new ideas and encourages others to value change.
Able to work effectively with new people and new teams.
Is proactive and takes steps to prepare for changes in the workplace.
Is flexible and open minded in dealing with others.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Actively seeks feedback from others.
Asks others for their ideas and opinions.
Seeks feedback to enhance performance.
Is easy to approach with ideas and opinions.
Shares past experiences with others as learning opportunities.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Time Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Keeps and maintains a To-Do list.
Leaves time in the schedule for unplanned contingencies.
Sets clearly defined goals.
Focuses on tasks that have high priority.
Avoids distractions in the workplace.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates a sense of responsibility and commitment to public trust.
Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
Demonstrates congruence between statements and actions.
Consistently keeps commitments.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Comes across as a reliable, committed team member
Effective team player
Facilitates team discussions and problem-solving
Creates a climate that encourages team participation.
Shares credit for accomplishments with team members
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Strategic Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understands their role within the organization.
Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
Communicates goals and objectives to employees.
Able to decline a poor strategy by proposing alternate strategies.
Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
If [Participant Name] were to make improvements in Strategic Focus, 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.