Mediation- 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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 this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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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Mediation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages parties to respond directly to each other's concerns in a respectful, structured manner.
Balances transparency with confidentiality to maintain trust and process integrity.
Adjusts expectations and goals based on parties' readiness, capacity, or constraints.
Obtains explicit permission before disclosing any information shared in private sessions.
Acts as an intermediary in the resolution of disputes.
If [Participant Name] were to make improvements in Mediation, what are your suggestions for how he/she can improve this?
Flexibility	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Capable of adapting workflows to accommodate new regulations or policies.
Is able to bounce back from obstacles.
Is versatile and resilient.
Is flexible in responding to customer needs.
Seeks opportunities to improve processes and procedures to benefit the department.
If [Participant Name] were to make improvements in Flexibility, what are your suggestions for how he/she can improve this?
Administrative Skill	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Analyzes RFQs or RFIs to understand the client's needs, specifications, and evaluation criteria.
Provides assistance to others in obtaining passports, visas, and other international travel documents.
Performs basic logistics such as arranging transfers, shuttles, taxis, or rideshares, to and from airports or event locations.
Reads and understands information and ideas presented in writing.
Conducts research, compile data, and prepare papers for consideration and presentation by executives, committees, and boards of directors.
If [Participant Name] were to make improvements in Administrative Skill, what are your suggestions for how he/she can improve this?
Goals	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Sets challenging stretch goals
Tracks quarterly and annual performance figures by comparing them to the previous year.
Evaluates the availability of resources, including time, money, equipment, and personnel, to establish the priority of goals.
Breaks down larger goals into smaller, manageable milestones with their own timelines.
Defines clear and specific goals.
If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Spends the most time and effort on critical tasks first.
Assesses current capabilities before committing to new requests from customers.
Uses a scheduler/planner to keep tasks organized and on time.
Prioritizes tasks for efficiency.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Excellence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Demonstrates the functional or technical skills necessary to do their job.
Demonstrates the analytical skills to do their job.
Takes a lot of pride in their work.
Keeps themselves and others focused on constant improvement.
Produces high quality work.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Recognition	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Offers recognition that is proportional to the accomplishment.
Engages in employee recognition activities.
Uses Spot awards or Extra Effort awards to help motivate employees.
Routinely recognizes employees to show appreciation for their work.
Plans specific awards for different levels of service.
If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Tracks and communicates the company's community contributions to reinforce accountability and pride.
Strives to maintain the company's edge by delivering high-quality, market-relevant offerings
Provides access to training, documentation, and expert support to help employees use resources effectively
Aligns departmental strategies with the company's long-term vision and objectives.
Empowers employees to participate in volunteer efforts and community service programs.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

41. Strengths
    
    
    
42. Areas for Development
    
    
    
43. Please give any final comments or suggestions for [Participant Name Here]'s assessment.