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
Works across boundaries within the organization.
Works effectively with people from other departments.
...treats others with respect and dignity.
Supports the efforts of other employees in implementing solutions to problems.
Able to see issues from others' perspectives.
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 clarification to avoid misunderstandings.
Accepts individual differences.
Participates in cultural training sessions/classes.
Shows respect in daily interactions
May advocate for others with different cultural backgrounds.
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
Persuades others to consider alternative points of view.
Understanding what others need.
Seeks to obtain consensus or compromise.
Attempts to persuade others rather than simply control them.
Has excellent influencing/negotiating skills.
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
Can take on new assignments.
Easily accepts new responsibilities.
Is open to changes in policies and procedures.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
Adjusts plans as needed based on changing conditions.
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
Can be counted on to do what they say they are going to do.
Develops goals and establishes objective measures of success.
Creates a consistent process for prioritizing work.
Defines roles, rights, and responsibilities of employees.
Implements and facilitates controls and processes that maintain the integrity of the organization.
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
Sets a good balance between work and family life.
Makes time for developing plans and schedules.
Completes tasks ahead of schedule.
Does not become flustered by deadlines and timelines.
Sets clearly defined goals.
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
Applies complex rules and regulations to maintain optimal system performance.
Adopts the implementation of new technology into the workplace.
Maximizes the use of new technology to deliver products and services.
Supports technical training and development of employees.
Understands and is committed to implementing new technologies.
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
Able to influence others to accept certain positions.
Establishes good working relationships with others.
Researches the needs of the other party to identify strengths and weaknesses of positions.
Leverages relationships with others to achieve goals.
Stays calm and focuses on the core issues to be discussed.
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.