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.
Addresses employee behavior problems effectively.
Conducts regular performance appraisals and feedback.
Provides clear, motivating, and constructive feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Adaptability	Agree	Unsure	Disagree	N/A
Is aware of changes in the environment.
Flexible and open to new ideas and encourages others to recognize the value of change.
Is flexible and open minded in dealing with others.
Can take on new assignments.
Effective in working with different personnel of the team.
Action	Agree	Unsure	Disagree	N/A
Initiates actions to get things done.
Approves purchase requests in a timely manner.
Works at a quick pace.
Gladly accepts new challenges and works on them with urgency.
Pursues goals with action to achieve success.
Continual Learning	Agree	Unsure	Disagree	N/A
Pursues learning that will enhance job performance.
Pursues self-improvement through continual learning.
Improves on their skill sets.
Pursues professional development opportunities when they arise.
Takes charge of their training and skills enhancement.
Cultural Awareness	Agree	Unsure	Disagree	N/A
Respects the views offered by individuals with different cultural backgrounds.
Recognizes and values individual and cultural differences.
Supports and mentors others that may have different cultural backgrounds.
Is sensitive to the similarities and differences that exist between cultures.
Communicates with others without the influence of racism.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
Ensures stakeholders are involved in the decision making process.
Able to express own goals and needs.
Persuades others to consider alternative points of view.
Attempts to persuade others rather than simply control them.
Develops a good rapport with others.
Delegation	Agree	Unsure	Disagree	N/A
Sets clear and reasonable expectations for others and follows through on their progress.
Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Clearly defines duties and tasks to be completed.
Allows employees to decide how they wish to complete the tasks.
Innovation	Agree	Unsure	Disagree	N/A
Takes risks to advance important ideas.
Develops new products and services.
Implements best practices within the department.
Searches for opportunities and innovative ways to improve the organization.
Solves problems with insight and understanding.
Results Oriented	Agree	Unsure	Disagree	N/A
Stays focused on solving problems and getting work done.
Has a strong drive to complete goals despite obstacles that may arise.
Helps others when free-time is available.
Encourages a high-energy, fun work environment and coaches others on how to do the same
Determines what resources will be needed to achieve the objectives.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Reviews documentation, processes and practices.
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Addresses issues quickly before they develop into major problems.
Develops a confidential reporting system to enable employees to anonymously report safety violations.
Keeps informed of various regulations 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.