Empowering Others- 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 .

Empowering Others	Agree	Unsure	Disagree	N/A
Trusts employees to complete tasks assigned.
Set clear goals for assignments.
Is aware of the skill levels of others.
Distributes the workload to subordinates.
Demonstrates confidence in the abilities of subordinates.
Administrative Skill	Agree	Unsure	Disagree	N/A
Able to develop, justify and present a budget.
Enthusiastic about taking on challenging projects.
Strong organizational skills to keep the workspace and department in order
Takes responsibility for decisions.
Completes reports on-time.
Leadership	Agree	Unsure	Disagree	N/A
Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
Holds others accountable for their actions.
Sets specific, measurable, and challenging goals.
Leads team to set goals, solve problems, and accomplish tasks.
Effectively leads others.
Technical	Agree	Unsure	Disagree	N/A
Willingly shares his/her technical expertise; sought out as resource by others
Seeks information from others as needed.
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Demonstrates mastery of the technical competencies required in his/her work.
Safety	Agree	Unsure	Disagree	N/A
Participates in safety training when available.
Commits adequate resources toward safety measures.
Participates in safety training when offered.
Keeps accurate safety records.
Is aware of OSHA safety guidelines.
Flexibility	Agree	Unsure	Disagree	N/A
Works effectively during periods of change.
Willing to try new ideas.
Encourages others to adopt new procedures.
Open to the perspectives/viewpoints of others.
Implements changes as a result of having listened to employees
Conflict Management	Agree	Unsure	Disagree	N/A
Identifies and takes steps to prevent potential confrontations.
Deals effectively with employee grievances.
Assists team members by helping them see the other point of view.
Discusses conflict situations with supervisor.
Clearly expresses expectations to others.
Vision	Agree	Unsure	Disagree	N/A
Expresses the Company vision in a way that is easily understood and adopted by employees.
Behaves in a way that is consistent with business values & code of conduct
Creates a positive vision of the future for the Company.
Communicates the vision and strategy of [Company]
Communicates a vision of where the Company needs to be in the future.

41. Overall, please rate the effectiveness of [Participant Name Here].
    

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

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.