Delegation - 360 Degree Feedback Survey Sample #7

Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, 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 twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between and .

Delegation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages and empowers subordinates to use initiative in achieving goals and objectives.
Allows subordinates to use their own methods and procedures.
Tells subordinates what to do, not how to do it.
Defines the roles, responsibilities, required actions, and deadlines for team members.
Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
If were to make improvements in Delegation, what are your suggestions for how he/she can improve this?
Excellence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is planful and organized.
Can be counted on to add value wherever they are involved.
Produces high quality work.
Takes a lot of pride in their work.
Keeps themselves and others focused on constant improvement.
If were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Demonstrates congruence between statements and actions.
Communicates an understanding of the other person's interests, needs and concerns.
Takes ownership, delivers on commitments
Works in a way that makes others want to work with her/him.
Consistently keeps commitments.
If were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Asks others for their ideas and opinions.
Shares past experiences with others as learning opportunities.
Is visible and approachable.
Is easy to approach with ideas and opinions.
Open to the suggestions of others.
If were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Co-worker Development	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
If were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?
Planning	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Anticipates obstacles and ways to overcome them.
Makes plans and follows through.
Works in an organized manner
If were to make improvements in Planning, what are your suggestions for how he/she can improve this?

30. Strengths
    
    
    
31. Areas for Development
    
    
    
32. Please give any final comments or suggestions for 's assessment.