Feedback - 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 .

Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Actively seeks feedback from others.
Open to the suggestions of others.
Considers other's opinion and suggestions.
Looks to others for input.
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?
Communication Skills	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Visible and approachable; is there when you need them.
Gives clear and convincing presentations.
Summarizes or paraphrases the current question to confirm understanding.
Communicates with department leadership
Summarizes the question to verify comprehension.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Always starts work on time.
Consistently strives to complete work on time or ahead of schedule.
Aware of the consequences for failure to complete the project.
Willingly accepts the obligation to complete the task.
Takes full responsibility for team's lack of progress.
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
Fosters a high standard of ethics and integrity.
Develops trust and confidence from others.
Fosters an environment built upon trust.
Demonstrates sincerity in actions with others.
Accepts responsibility for mistakes.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?
Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets an example for others to follow
Delegate tasks effectively
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Is ready to offer help
If [Participant Name] were to make improvements in Management, what are your suggestions for how he/she can improve this?
Decision Making	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Facilitates meetings with others to try to consider alternative courses of action.
Makes decisions that support the department's goals and objectives.
Weighs the pros and cons of decisions.
Makes decisions independently (without having to be told what or how).
Makes decisions based on novel interpretations of the facts.
If [Participant Name] were to make improvements in Decision Making, what are your suggestions for how he/she can improve this?
Technical	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Demonstrates mastery of the technical competencies required in his/her work.
Seeks information from others as needed.
Knows how to produce high quality products/work.
Is knowledgeable of procedures or systems necessary for the job.
Willingly shares his/her technical expertise; sought out as resource by others
If [Participant Name] were to make improvements in Technical, what are your suggestions for how he/she can improve this?
Managing Risk	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Create continuity plans.
Views risks as potential opportunities for profit.
Anticipates the consequences of different potential risk events.
Promotes risk management competence throughout the organization.
Attends risk management seminars and conferences.
If [Participant Name] were to make improvements in Managing Risk, what are your suggestions for how he/she can improve this?
Co-worker Development	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets and clearly communicates expectations, performance goals, and measurements to others
Adapts coaching and mentoring approach to meet the style or needs of individuals
Provides ongoing feedback to co-workers on their development progress
Works to identify root causes of performance problems
Gives others development opportunities through project assignments and increased job responsibilities
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?
Strategic Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Effective in strategy formulation and execution.
Ensures the department has a viable strategy for moving forward.
Makes strategic changes to stay ahead of changes in the business environment.
Successfully implements a strategic plan.
Aligns projects to the strategic goals of the company.
If [Participant Name] were to make improvements in Strategic Focus, what are your suggestions for how he/she can improve this?
Organizational Fluency	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understands the current organizational culture.
Anticipates problems that may affect the department.
Gets things done through the department.
Understands departmental policies and procedures.
Able to deal with sensitive issues with tact and professionalism.
If [Participant Name] were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?

56. Strengths
    
    
    
57. Areas for Development
    
    
    
58. Please give any final comments or suggestions for [Participant Name Here]'s assessment.