Initiative - 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 .

Initiative	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Goes above and beyond the stated goals.
Immediately works to complete goals well before their deadline.
Prepares for unexpected contingencies.
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Takes action without being asked.
If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?
Client Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is pro-active in dealing with clients and addressing their needs.
Ensures client commitments and requirements are met or exceeded
Looks for opportunities that have a positive impact on Clients.
Satisfies client needs.
Forms strong client relationships
If [Participant Name] were to make improvements in Client Focus, what are your suggestions for how he/she can improve this?
Customer Focus	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Develops strong customer relationships.
...friendliness and courtesy
Consistently models positive customer service attitudes.
Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
Ensures all customer commitments and requirements are met or exceeded.
If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?
Co-worker Development	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Takes immediate action on poor performance
Sets and clearly communicates expectations, performance goals, and measurements to others
Works to identify root causes of performance problems
Adapts coaching and mentoring approach to meet the style or needs of individuals
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?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Seeks and listens to other's contributions
Creates opportunities to learn with other team members
Creates a culture that fosters and values collaboration.
Fosters teamwork rather than individual competition
Encourages collaboration with other departments.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Fiscal Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Develops budgets and plans for various programs and initiatives.
Monitors spending.
Monitors expenses and verifies the need for items purchased.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Ensures others follow the correct rules and regulations on fiscal matters.
If [Participant Name] were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

31. Strengths
    
    
    
32. Areas for Development
    
    
    
33. Please give any final comments or suggestions for [Participant Name Here]'s assessment.