Coaching- 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 .

Coaching	Agree	Unsure	Disagree	N/A
Helps employees to understand responsibilities, authority, and expectations.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Conducts regular performance appraisals and feedback.
Provides clear, motivating, and constructive feedback.
Helps employees to maintain high personal standards.
Adaptability	Agree	Unsure	Disagree	N/A
Continually trying to improve skills to remain current.
Handles changes easily.
Adjusts to new plans and procedures.
Effective in working with different personnel of the team.
Works effectively with various personalities of team members.
Action	Agree	Unsure	Disagree	N/A
Motivates & supports others to gain skills
Makes effective decisions, even when under pressure.
Effectively makes decisions
Works quickly when faced with difficult problems.
Displays high energy and enthusiasm on consistent basis.
Continual Learning	Agree	Unsure	Disagree	N/A
Builds on their strengths while addressing their weaknesses.
Views setbacks as opportunities to learn from.
Participates in regular training offered.
Is open to new ideas and concepts.
Sets relevant learning objectives and goals.
Cultural Awareness	Agree	Unsure	Disagree	N/A
Is aware of differences in how individuals from other cultures greet one another.
Effective in working with individuals with a variety of cultural backgrounds.
Develops skills and attitudes to bridge cultural differences.
Avoids referring to stereotypes about others from different cultures.
Seeks to reduce obstacles in communication that might arise from cultural differences.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
Attempts to persuade others rather than simply control them.
Communicates effectively with others.
Persuades others to consider alternative points of view.
Develops a good rapport with others.
Has excellent influencing/negotiating skills.
Delegation	Agree	Unsure	Disagree	N/A
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Allows employees to decide how they wish to complete the tasks.
Allows subordinates to use their own methods and procedures.
Assigns tasks to create learning opportunities for the employees.
Clearly defines duties and tasks to be completed.
Innovation	Agree	Unsure	Disagree	N/A
Fosters a creative and innovative work environment.
Develops new products and services.
Creates a safe environment for idea-sharing.
Creates improved methods or solutions for meeting goals and objectives.
Offers constructive improvements to existing systems.
Results Oriented	Agree	Unsure	Disagree	N/A
Helps others when free-time is available.
Directs team in prioritizing daily work activities
Does not become distracted by non-issues or interruptions.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Inspires and motivates co-workers to be productive and energetic at work
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Complies with regulatory requirements for the state.
Keeps up-to-date with legislation affecting employees.
Is aware of the documents and reports needed to maintain compliance with regulations.
Keeps informed of various regulations and procedures.
Creates and maintains necessary regulatory documentation.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.