Commitment to Result - 360 Degree Feedback Survey Sample #3

Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make a great company.

Please ensure that your submission is made between and . The survey will only be available during these dates.

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Commitment To Result	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Maintains persistence and dedication to achieving results.
Able to focus on a task even when working alone.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Creates a sense of urgency among the store team members to complete activities, which drive sales.
Committed to the team.
Please feel free to provide any comments to help explain your answers?
Flexibility	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Effective in incorporating new ideas.
Acts decisively in frequently changing and uncertain environment.
Able to adapt to new situations.
Implements changes as a result of having listened to employees
Adapts to circumstances as needed.
Please feel free to provide any comments to help explain your answers?
Creativity	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Conceives, implements and evaluates ideas.
Develops solutions to challenging problems.
Inspires creativity in their team.
Creates a lot of new ideas.
Adds value to the department/organization.
Please feel free to provide any comments to help explain your answers?
Cultural Awareness	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Fosters a diverse workforce free from discrimination and harassment.
Values the opinions of diverse groups and individual.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Treats others with dignity and respect.
Respects others regardless of age, race, gender, nationality, or disability.
Please feel free to provide any comments to help explain your answers?
Performance	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Effective in performing his/her job.
Has great overall performance
Sets a high standard for job performance.
Works effectively in the department.
...Overall Performance
Please feel free to provide any comments to help explain your answers?
Change Management	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Works cooperatively with others to implement changes.
Supports the Company's efforts to implement changes.
Effective in dealing with ambiguous and challenging situations.
Addresses organizational and departmental resistance to changes.
Supports new initiatives for organizational changes to improve effectiveness.
Please feel free to provide any comments to help explain your answers?
Objectives	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Effectively organizes resources and plans
Encourages me to take on greater responsibility.
Able to organize work.
Organizes and schedules events, activities, and resources.
Works toward achieving established goals and objectives.
Please feel free to provide any comments to help explain your answers?
Teamwork	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Actively participates as a team member
Creates a climate that encourages team participation.
Communicates well with team members.
Builds consensus and shares relevant information.
Actively participates in the work of teams; seeks and listens to others' contributions
Please feel free to provide any comments to help explain your answers?
Planning	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Delegates role to team members to accomplish goals.
Makes plans and follows through.
Anticipates obstacles and ways to overcome them.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Able to identify the needs of the department before a major change.
Please feel free to provide any comments to help explain your answers?

46. Overall, please rate the effectiveness of .
    

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

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for 's assessment.