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 .

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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.
Helps employees to maintain high personal standards.
Develops the skills and capabilities of others.
Meets regularly with employees to coach them on areas that will enhance their performance
Adaptability	Agree	Unsure	Disagree	N/A
Adapts quickly to new situations.
Adjusts plans to meet the needs of new constraints.
Able to step in and help co-workers when needed.
Able to adjust to changes as needed.
Flexible and open to new ideas and encourages others to recognize the value of change.
Action	Agree	Unsure	Disagree	N/A
Seeks out opportunities to contribute beyond assigned responsibilities.
Effectively handles multiple complex issues simultaneously.
Takes advantage of opportunities to move the organization forward.
Takes action to respond to dissatisfied customer.
Creates performance measures to ensure action by the department.
Continual Learning	Agree	Unsure	Disagree	N/A
Pursues learning that will enhance job performance.
Improves on their skill sets.
Sets relevant learning objectives and goals.
Is open to new ideas and concepts.
Takes the initiative to learn new skills.
Cultural Awareness	Agree	Unsure	Disagree	N/A
Accepts individual differences.
Respects others regardless of age, race, gender, nationality, or disability.
Is aware of differences in how individuals from other cultures greet one another.
Engages with individuals that have different cultural backgrounds.
Aware of their own cultural views.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
Develops a good rapport with others.
Understanding what others need.
Ensures stakeholders are involved in the decision making process.
Communicates effectively with others.
Persuades others to consider alternative points of view.
Delegation	Agree	Unsure	Disagree	N/A
Allows employees to decide how they wish to complete the tasks.
Assigns tasks to create learning opportunities for the employees.
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Entrusts subordinates with important tasks.
Allows subordinates to use their own methods and procedures.
Innovation	Agree	Unsure	Disagree	N/A
Looks beyond company for new ideas and innovative approaches.
Determines how much risk the company is willing to take in implementing innovations to the products and services.
Offers solutions to problems when talking with clients.
Takes risks that often yield rewards.
Prioritizes technical skill development among employees to foster a culture of innovation and creativity.
Results Oriented	Agree	Unsure	Disagree	N/A
Provides clear expectations for employees.
Has a strong result orientation.
Determines what resources will be needed to achieve the objectives.
Makes changes to the plans if it will result in increased output.
Measures progress toward the goal.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Ensures regulations are followed as required.
Identifies and assesses areas of regulatory or compliance risk.
Performs audits regularly, or without notice, to ensure proper compliance with regulations.
Ensures the company is in compliance with all laws regarding the production and transportation of product.
Formulates compliance policies and procedures.

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.