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
Facilitates reaching agreement between the two parties.
Listens without judgment and reflects back concerns to show understanding and care.
Reframes language or tone to maintain constructive dialogue.
Guides parties through impasse by reframing issues and exploring alternative solutions.
Structures the negotiation process to promote clarity, fairness, and progress toward resolution.
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
Innovates skills and modifies behaviors to remain flexible in addressing important issues.
Is able to change their approach to solving a problem based on new information.
Is able to bounce back from obstacles.
Will pivot strategies, operations, or processes in real-time to meet new challenges or seize new opportunities.
Recognizes and quickly adapts to shifts in the environment, market, or industry.
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
Maintains appropriate levels of supplies and re-orders supplies as needed.
Effective at scheduling project activities and assignments.
Implements and uses performance measures.
Has effective oral and written communication skills.
Organizes files, maintains records, and coordinates document workflows.
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
Conducts timely follow-up; keeps others informed on a need to know basis.
Creates or uses existing tools to collect and analyze data from sources such as surveys, financial reports, or log files.
Prioritizes tasks and delegates when necessary to efficiently allocate time, resources and efforts to the completion of goals.
Adheres to established schedules and timelines to effectively achieve goals.
Recognizes that some tasks depend on the completion of other tasks and schedules them accordingly.
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
Celebrates team wins and progress during high-pressure periods to reinforce collective efficacy.
Determines if specific tasks should be delegated to subordinates.
Breaks down complex projects into prioritized, manageable components.
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Leads cross-departmental initiatives while maintaining accountability for the team's performance.
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
Is planful and organized.
Can be counted on to add value wherever they are involved.
Keeps themselves and others focused on constant improvement.
Demonstrates the functional or technical skills necessary to do their job.
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 reflects the employee's strengths, dedication, and values.
Measures improvements in performance from recognition programs.
Uses both formal and informal rewards to recognize employees.
Creates recognition programs that drive improvements in organizational performance.
Matches the reward to the person being recognized.
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
Attends [Company] gatherings and social events.
Promotes a speak-up culture where ethical concerns are welcomed and addressed constructively.
Facilitates the strategic changes necessary to ensure the organization is able to compete effectively in the marketplace.
Maintains positive relationships between the [Company] and the community.
Makes sure employees have a sense of belonging and purpose in the organization.
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.