Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #8

Instructions

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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Juggling Multiple Responsibilities	Agree	Unsure	Disagree	N/A
Is aware of the deadlines for specific tasks/assignments.
Determines which tasks are critical and which tasks are optional.
Assesses current capabilities before committing to new requests from customers.
Prioritizes tasks for efficiency.
Keeps track of multiple assignments and deadlines.
Bias for Action	Agree	Unsure	Disagree	N/A
Displays high energy and enthusiasm on consistent basis.
Encourages risk taking and experimentation to improve performance
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Coach others to foster an environment which can adapt quickly and willingly to rapid change.
Seeks and utilizes opportunities for continuous learning and self-development.
Objectives	Agree	Unsure	Disagree	N/A
Works toward achieving established goals and objectives.
Assures [Company] principles are understood, employed & pursued.
Able to organize work.
Organizes and schedules events, activities, and resources.
Establishes goals and objectives.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example
Acts as a resource without removing individual responsibility.
Behavior is ethical and honest.
...takes personal responsibility for results.
Holds herself / himself accountable to goals / objectives
Business Acumen	Agree	Unsure	Disagree	N/A
Identifies new business opportunities.
Periodically assesses the current market environment.
Aware of regulations that impact our business.
Calculates return on investment (ROI) for various business projects.
Seeks to better understand other areas of the company, including their operations, personnel, and output.
Continual Learning	Agree	Unsure	Disagree	N/A
Views setbacks as opportunities to learn from.
Pursues learning that will enhance job performance.
Shares best practices with others and learns from others.
Sets relevant learning objectives and goals.
Improves on their skill sets.
Feedback	Agree	Unsure	Disagree	N/A
Considers other's opinion and suggestions.
Looks to others for input.
Accepts the views of others.
Shares past experiences with others as learning opportunities.
Actively seeks feedback from others.
Attitude	Agree	Unsure	Disagree	N/A
Contributes to a positive work environment.
Treats all people fairly and with respect.
Builds open and trusting relationships.
Shows by their actions that they trust in the positive intentions of others.
Works to eliminate unnecessary work or barriers that get in others' way.
Goals	Agree	Unsure	Disagree	N/A
Makes sure that team members have a clear idea of our group's goals.
Understands & contributes to development of strategic goals.
Makes sure that I have a clear idea of our group's goals.
Goal Setting
Achieves established goals.
Change Management	Agree	Unsure	Disagree	N/A
Supports the Company's efforts to implement changes.
Is an inspiration for others to accept the recent changes.
Works cooperatively with others to implement changes.
Inspires others to accept changes.
Inspires others to want to change.
Technical	Agree	Unsure	Disagree	N/A
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Is knowledgeable of procedures or systems necessary for the job.
Demonstrates mastery of the technical competencies required in his/her work.
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Partnering/Networking	Agree	Unsure	Disagree	N/A
Collaborates with others to accomplish goals and objectives.
Supports a partnering/networking culture.
Creates value within the Company by building networks.
Seeks to reduce institutional roadblocks to information sharing.
Seeks an understanding of diverse functions within the Company.
Strategic Insight	Agree	Unsure	Disagree	N/A
Identifies root causes of problems.
Understands how to strategically grow the business and increase customers.
Converses with customers and clients to get a better insight into their personal needs.
Lets employees know how their roles contribute toward the achievement of strategic company objectives.
Adjusts strategic plans based on insights gathered from different points of view.

66. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
67. Strengths
    
    
    
68. Areas for Development
    
    
    
69. Please give any final comments or suggestions for [Participant Name Here]'s assessment.