Initiative - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

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	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Builds strong interpersonal relationships upon first meeting.
Is a self-starter. Does not wait to be told to do something.
Cleans the workspace without being told.
Immediately informs the HR Department of any personnel complaints or issues.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Acts quickly to address any issues or problems.
Is proactive when preparing for potential problems or critical events.
Actively works on resolving the issue instead of procrastinating or hoping it will resolve itself.
Initiates the development of new products.
If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?
Action	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Addresses safety issues immediately.
Takes steps to prepare for the start of the project.
Works quickly when faced with difficult problems.
Acts immediately instead of waiting for someone else to solve the issue.
Takes the initiative and does not wait for the situation to change.
Sets high standards for themselves and others.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?
Planning	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Creates a timeline to specify when each phase of the project should be concluded.
Has plans to handle unexpected events.
Always has a "Plan-B" ready if needed.
Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
Accomplishes major tasks by breaking them into manageable pieces.
Determines what supplies/equipment will be needed for the department.
If [Participant Name] were to make improvements in Planning, what are your suggestions for how he/she can improve this?
Integrity	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Fosters an environment built upon trust.
Demonstrates honesty and truthfulness at all times.
Demonstrates sincerity in actions with others.
Fosters a high standard of ethics and integrity.
Follows tasks to completion.
Maintains strong relationships with others.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?
Professional Development	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Contributing fully to the extent of their skills
Quickly acquire and apply new knowledge and skills when needed
Encourages employees to take courses relevant to their job.
Allows employees to fully participate in employee training and professional development.
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for continuous learning.
If [Participant Name] were to make improvements in Professional Development, what are your suggestions for how he/she can improve this?
Cultural Awareness	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Understands what customs and etiquette are important for individuals from other cultures.
Understands how implicit biases can affect decisions, communication and productivity.
Understands the impact that our culture may have on interactions between individuals.
Recognizes and values individual and cultural differences.
Fosters a diverse workforce free from discrimination and harassment.
Aware of their own cultural views.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Encourages team members to offer opinions and ideas.
Ensures that all members are aligned and motivated, contributing to a cohesive and productive team dynamic.
Develops networks and builds alliances with employees throughout the company.
Encourages teammates to settle their differences and work together.
Uses effective strategies to re-engage team members and secure their commitment to the business's common good.
Builds an environment of trust and respect to encourage risk-taking, innovation, and sharing of ideas.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?

46. Strengths
    
    
    
47. Areas for Development
    
    
    
48. Please give any final comments or suggestions for [Participant Name Here]'s assessment.