Establishing Focus/Direction - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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 this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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 .

Establishing Focus/Direction	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets appropriate goals for employees.
Helps guide employees with prioritizing tasks.
Maintains self-control when personally criticized.
Maintains focus when handling several problems or tasks simultaneously.
Aligns the department's goals with the goals of the organization.
If [Participant Name] were to make improvements in Establishing Focus/Direction, what are your suggestions for how he/she can improve this?
Change Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to get team members to change their attitudes.
Supports the Company's efforts to implement changes.
Facilitates change with minimal resistance.
Adopts changes to set and example for others to follow.
Is a leading force driving changes.
If [Participant Name] were to make improvements in Change Management, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Holds employees accountable for completing the project successfully.
Takes ownership of mistakes and learns from them.
Takes responsibility for the team's actions and results.
Accepts personal responsibility for producing high quality and timely work.
Takes charge of addressing and solving problems.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Integrity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Demonstrates sincerity in actions with others.
Establishes relationships of trust, honesty, fairness, and integrity.
Protects the integrity and confidentiality of information
Fosters a high standard of ethics and integrity.
Demonstrates honesty and truthfulness at all times.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Accepts the views of others.
Shares past experiences with others as learning opportunities.
Looks to others for input.
Asks others for their ideas and opinions.
Is easy to approach with ideas and opinions.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Managing Risk	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Decides what actions will be taken.
Develops policies to address risk situations in the workplace.
Perceives the risks of different work tasks and activities.
Identifies what actions the organization is willing to take.
Knows how to obtain desired results with minimal losses.
If [Participant Name] were to make improvements in Managing Risk, what are your suggestions for how he/she can improve this?
Safety	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Ensures compliance with safety regulations.
Ensures that all supervisors are aware of regulatory and compliance measures.
Performs work safely.
Supports safety programs and procedures.
Mitigates hazards and safety issues that arise.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?
Interpersonal Skills	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Values the opinions of others.
Uses knowledge and charisma rather than position, power, or coercion to influence others
Keeps commitments made with coworkers.
Works diligently to assist customers in finding the right products.
Applies appropriate communication techniques to the situation.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Avoids micromanaging their employees.
Provides support and resources needed to accomplish goals.
Encourages others to obtain necessary skills and training.
Permits employees to take training to become more independent.
Provides opportunities for employee development and growth.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages collaboration with other departments.
Demonstrates compassion and respect for others through actions; is concerned about their work and non-work issues
Lets team members know when they have done well.
Fosters an environment that promotes active listening on the team.
Promotes a team spirit within and outside department; partners with other groups.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

51. Strengths
    
    
    
52. Areas for Development
    
    
    
53. Please give any final comments or suggestions for [Participant Name Here]'s assessment.