Others- 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is 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 '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 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 .

Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Includes others in the decision making processes.
Helpful
Consistently demonstrates ability and willingness to trust others.
Respects the opinions of other employees.
Treats others with respect and dignity.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?
Cultural Awareness	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Seeks out different viewpoints and benefits from different perspectives.
Seeks clarification to avoid misunderstandings.
Encourages a work environment where individual differences are valued.
Supports and mentors others that may have different cultural backgrounds.
Understands how their own cultural background can impact the way they communicate and interact with others.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?
Persuasion and Influence	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understanding what others need.
Attempts to persuade others rather than simply control them.
Persuades others to consider alternative points of view.
Develops a good rapport with others.
Communicates effectively with others.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is open to new ideas and innovations.
Adjusts priorities to changing business goals.
Handles changes easily.
Able to step in and help co-workers when needed.
Develops insights and applies innovative solutions to projects and problems.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Accountability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Informs supervisor of progress without having to be asked about it.
Takes ownership of problems to find the best solutions.
Consistently exhibits professionalism in interactions with employees.
Is prepared and on time for meetings and scheduled events.
Acknowledges errors and takes the steps necessary to rectify them.
If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?
Time Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Uses agendas when chairing or facilitating meetings.
Manages the workload effectively in order to stay on schedule.
Effectively uses subordinates to help get more work done by the department.
Does not procrastinate.
Completes work on a timely basis.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?
Technology Use/Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Supports employee training and development initiatives regarding implementation of technology.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
Understands and is committed to implementing new technologies.
Uses technology in decision making and problem solving.
If [Participant Name] were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?
Negotiation	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Influences others through rational argument and persuasion.
Able to say "no" when it is essential to maintaining quality and high standards.
Actively listens to conversations to be able to recall important details later.
Understands the expectations of other parties in the negotiation.
Maintains communication channels between parties in the negotiation.
If [Participant Name] were to make improvements in Negotiation, 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.