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 .

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Establishing Focus/Direction	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Makes sure that employees understand and identify with the team's mission.
Maintains focus when handling several problems or tasks simultaneously.
Sets appropriate goals for employees.
Makes sure that employees understand how their work relates to organizational goals.
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
Adopts changes to set and example for others to follow.
Supports the Company's efforts to implement changes.
Addresses organizational and departmental resistance to changes.
Effective in dealing with ambiguous and challenging situations.
Facilitates change with minimal resistance.
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
Willingly accepts the consequences for their actions.
Accepts accountability for their work.
Takes responsibility for their actions and admits mistakes openly.
Requires employees to submit monthly reports of the work they performed.
Reviews performance to determine areas for improvement.
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
Follows tasks to completion.
Fosters a high standard of ethics and integrity.
Accepts responsibility for mistakes.
Establishes relationships of trust, honesty, fairness, and integrity.
Does what was promised.
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
Open to the suggestions of others.
Actively seeks feedback from others.
Is visible and approachable.
Is easy to approach with ideas and opinions.
Looks to others for input.
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
Identifies opportunities that may be created by taking specific risks.
Recognizes that small changes may snowball into major events.
Establish roles, responsibilities, procedures.
Monitors enterprise risk management activities for their impact and effectiveness on mitigating risks.
Prioritizes risks to act on critical issues first.
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
Develops a strong safety culture.
Encourages others to work safely.
Ensures that all supervisors are aware of regulatory and compliance measures.
Is not afraid to question a potential safety issue observed in the workplace.
Identifies predictable hazards in the workplace.
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
Comes across as credible, knowledgeable and sincere
Builds a strong rapport with co-workers.
Gives good advice and suggestions to coworkers.
Embraces the differences in individuals that comprise the team.
Able to work with individuals at all levels of the Company.
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
Allows for flexibility in the working hours.
Trusts employees to complete tasks assigned.
Avoids micromanaging their employees.
Provides opportunities for employee development and growth.
Lets employees make their own decisions.
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
Communicates well with team members.
Helps the team to bounce back from obstacles.
Encourages dialog between team members.
Is open to new ideas that may change own goals for benefit of the team
Applies knowledge of team behavior to help achieve organizational goals and objectives.
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.