Change Management - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

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 .

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Change Management	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Develops a strategy for implementing changes.
Adopts changes to set and example for others to follow.
Able to get department employees to accept new changes.
Effective in dealing with ambiguous and challenging situations.
Addresses organizational and departmental resistance to changes.
Develops plans for following through on the changes.
Inspires others to want to change.
Is a leading force driving changes.
Facilitates change with minimal resistance.
If [Participant Name] were to make improvements in Change Management, what are your suggestions for how he/she can improve this?
Objectives	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Communicates goals and objectives to employees.
Works toward achieving established goals and objectives.
Organizes and schedules events, activities, and resources.
Consistently provides me with timely feedback for improving my performance.
Assures [Company] principles are understood, employed & pursued.
Sets long-term and short-term goals.
If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?
Interpersonal Skills	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Values the opinions of others.
Embraces the differences in individuals that comprise the team.
Appreciates the extra efforts made by coworkers.
Is transparent and honest in communications, intentions, and actions.
Is thoughtful and honest about the feedback they give others.
Pays close attention to what is being communicated verbally and nonverbally.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Builds an environment of trust and respect to encourage risk-taking, innovation, and sharing of ideas.
Devotes time and energy to empower the team to succeed.
Ensures relevant data is available to all committee members.
Involves others in reaching a consensus during group activities.
Is a dependable partner in the group.
Readily shares information with other group members.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Upholds ethical standards even when no one is watching.
Provides clear reasons for underperformance.
Regularly completes tasks on time.
Accepts accountability for their actions and results.
Consistently follows through on commitments and promises.
Always keeps the supervisor informed of relevant information.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Establishing Focus/Direction	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Maintains self-control when personally criticized.
Functions well under stress, deadlines, and/or significant workloads.
Sets appropriate goals for employees.
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand how their work relates to organizational goals.
Makes sure that employees understand and identify with the team's mission.
If [Participant Name] were to make improvements in Establishing Focus/Direction, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Creates a work environment that fosters positive feedback to employees.
Sets performance objectives for subordinates that encourages development opportunities.
Creates opportunities for professional development.
Encourages employees through recognition of positive changes in behavior.
Is open to receiving feedback.
Recognizes and celebrates accomplishments of others.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

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