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 .

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Initiative	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Maintains momentum on long-term initiatives despite shifting priorities or limited support.
Persists in stakeholder engagement even when initial outreach is met with resistance or indifference.
Seizes upon opportunities available.
Creates solutions to problems as soon as an incident occurs.
Acts on own initiative to improve the department outcomes.
Guides strategic initiatives to advance the department/organization.
Does things without being told.
Independently seeks out new learning opportunities to improve their skills.
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
Sets high standards for themselves and others.
Does not procrastinate when there is a job to be done.
Establishes the tasks and direction for the team.
Successfully makes progress despite repeated failures or setbacks at work.
Undertakes actions to achieve specific goals.
Displays high energy and enthusiasm on consistent basis.
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
Understands what equipment will be needed for the project.
Understands what materials will be required to successfully implement the plan.
Creates plans to handle complex, multi-faceted projects.
Prioritizes tasks and allocates resources.
Prioritizes tasks based on urgency/need.
Develops proper plans to ensure seamless flow of materials through logistics.
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
Shows steadfast integrity, dedication, and excellence, persistently seeking to make a meaningful impact and bolster the company's success.
Is open and honest in communications.
Recognizes integrity as a core value of the organization.
Builds trust within the organization and with external stakeholders by owning up to mistakes.
Maintains integrity as a core principle.
Encourages and practices inclusivity in meetings and discussions, ensuring all voices are heard and valued.
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
Seeks opportunities for continuous learning.
Contributing fully to the extent of their skills
Allows employees to fully participate in employee training and professional development.
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for professional development.
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
Effective in working with individuals with a variety of cultural backgrounds.
Views diversity as a strength, not as an issue.
Encourages inclusive participation in culturally significant events and observances
Welcomes diverse cultural input when shaping organizational strategy or policy.
Recognizes individual and cultural differences.
Tailors solutions to accommodate diverse cultural needs and expectations.
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
Is a trustworthy and credible partner.
Develops networks and builds alliances across departments.
Collaborates with team members to achieve common goals.
Understands that collaboration often leads to more innovative and effective solutions.
Builds consensus among team members.
Regularly seeks feedback from employees on how to improve collaboration and acts on their suggestions.
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.