Initiative - 360 Degree Feedback Survey Sample #1

Instructions:

The is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between and . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Initiative	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Prepares for unexpected contingencies.
Seeks and utilizes opportunities for continuous learning and self-development.
Immediately works to complete goals well before their deadline.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
If were to make improvements in Initiative, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Plans and organizes continuously while performing all other responsibilities and activities.
Bounces back from daily crisis, disappointments and frustrations.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
If were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
Flexible and open to new ideas and encourages others to value change.
Learns from personal experiences and/or mistakes.
Able to work effectively with new people and new teams.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
If were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Self Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Steps away from a situation to process appropriate response.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Analyzes interpersonal problems instead of reacting to them.
If were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Leadership	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Effectively leads others.
Able to influence others.
Demonstrates leadership and courage in critical situations.
Gives direct, constructive, and actionable feedback.
Takes ownership and accountability for results
If were to make improvements in Leadership, what are your suggestions for how he/she can improve this?
Achievement	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Demonstrates a well-organized and timely approach to achieve desired results
Accepts setbacks and challenges as improvement opportunities
Completes work to given time frame and to budget
Follows-up and takes action when goals are not met to ensure better results in the future.
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
If were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Excellence	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Keeps themselves and others focused on constant improvement.
Takes a lot of pride in their work.
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.
Produces high quality work.
If were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Consistently keeps commitments.
Demonstrates a sense of responsibility and commitment to public trust.
Builds and maintains the trust of others.
Is trustworthy; is someone I can trust.
Delivers on promises made.
If were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Coaching	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Meets regularly with employees to coach them on areas that will enhance their performance
Conducts regular performance appraisals and feedback.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Addresses employee behavior problems effectively.
Provides clear, motivating, and constructive feedback.
If were to make improvements in Coaching, what are your suggestions for how he/she can improve this?
Entrepreneurship	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Able to adapt the department to changing business demands and climate.
Devotes a certain amount of time and effort to developing new business opportunities.
Finds unique ways to go around barriers to success.
Encourages dynamic growth opportunities.
Has a strategic awareness on how to promote the organization.
If were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?
Fiscal Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Provides budgeting and accounting support to the Company.
Develops budgets and plans for various programs and initiatives.
Ensures others follow the correct rules and regulations on fiscal matters.
Keeps excellent records for financial transparency.
Effective in using Company's resources.
If were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

56. What are 's greatest strengths demonstrated this year?
    
    
    
57. What are 's areas for development?
    
    
    
58. Please give any final comments or suggestions for 's assessment.