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

360 Feedback Survey

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 .

Establishing Focus/Direction	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Stays focused even when under pressure and stress.
Functions well under stress, deadlines, and/or significant workloads.
Maintains self-control when personally criticized.
Excellent at managing time.
Makes sure that employees understand and identify with the team's mission.
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.
Addresses organizational and departmental resistance to changes.
Facilitates change with minimal resistance.
Develops plans for following through on the changes.
Inspires others to want to change.
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
Defines roles, rights, and responsibilities of the team.
Is aware of problems or issues that may affect the organization.
Tackles issues head on and finds solutions.
Takes ownership of mistakes and learns from them.
Takes responsibility for results.
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.
Does what was promised.
Demonstrates sincerity in actions with others.
Develops trust and confidence from others.
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
Seeks feedback to enhance performance.
Actively seeks feedback from others.
Looks to others for input.
Considers other's opinion and suggestions.
Is visible and approachable.
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
Creates a risk management strategy for the department.
Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
Performs regular risk analyses to minimize adverse outcomes.
Develops policies to address risk situations in the workplace.
Perceives the risks of different work tasks and activities.
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
Works to implement corrective safety measures.
Encourages others to attend safety training.
Develops safety guidelines for the department.
Develops a strong safety culture.
Performs work safely.
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
Expresses appreciation of other's work.
Anticipates the concerns of other employees.
Is trusted by peers and co-workers; others are willing to confide in him/her
Builds a strong rapport with co-workers.
Provides constructive feedback in a way that fosters acceptance and development.
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 employees to make their own decisions.
Set clear goals for assignments.
Gives employees autonomy to complete tasks on their own.
Assigns tasks that are within the skill levels of employees.
Encourages others to obtain necessary skills and training.
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
Seeks and listens to other's contributions
Encourages collaboration with other departments.
Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
Communicates a clear message that teamwork and collaboration are expected.
Communicates well with team members.
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.