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
Addresses employee behavior problems effectively.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Develops the skills and capabilities of others.
Provides clear, motivating, and constructive feedback.
Conducts regular performance appraisals and feedback.
Adaptability	Agree	Unsure	Disagree	N/A
Able to adjust to changing environments.
Adjusts to the new vision and mission of the company.
Able to step in and help co-workers when needed.
Works effectively in dynamic and changing work environments.
Able to adjust to changes as needed.
Action	Agree	Unsure	Disagree	N/A
Overcomes obstacles that may impede progress on a task.
Is driven to complete a high amount of work.
Works at a quick pace.
Creates opportunities and then takes advantage of them.
Gets the job done.
Continual Learning	Agree	Unsure	Disagree	N/A
Pursues learning that will enhance job performance.
Is open to new ideas and concepts.
Pursues self-improvement through continual learning.
Builds on their strengths while addressing their weaknesses.
Improves on their skill sets.
Cultural Awareness	Agree	Unsure	Disagree	N/A
Seeks out different viewpoints and benefits from different perspectives.
Willing to work with employees who have different cultural backgrounds.
Seeks opportunities to learn about the other cultural backgrounds of colleagues.
Values the opinions of diverse groups and individual.
Helps other employees to become more culturally sensitive.
Persuasion and Influence	Agree	Unsure	Disagree	N/A
Attempts to persuade others rather than simply control them.
Ensures stakeholders are involved in the decision making process.
Persuades others to consider alternative points of view.
Able to express own goals and needs.
Understanding what others need.
Delegation	Agree	Unsure	Disagree	N/A
Tells subordinates what to do, not how to do it.
Clearly defines duties and tasks to be completed.
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
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.
Innovation	Agree	Unsure	Disagree	N/A
Searches for opportunities and innovative ways to improve the organization.
Develops innovative products or services.
Creates new products or services.
Improves and makes systems more efficient.
Optimizes innovative ideas for maximum success.
Results Oriented	Agree	Unsure	Disagree	N/A
Views obstacles as opportunities to improve self.
Always willing to help coworkers to keep productions levels high.
Keeps track of progress toward the results.
Does not become distracted by non-issues or interruptions.
Works toward achievement of goals even when confronted with obstacles.
Regulatory/Compliance	Agree	Unsure	Disagree	N/A
Keeps up-to-date with legislation affecting employees.
Reviews the compliance program and recommends changes based on new industry trends.
Establishes clear communication channels and lines of communication for compliance related issues.
Prepares and presents annual reports as required.
Keeps detailed records of compliance measures.

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.