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
Helpful
Includes others in the decision making processes.
Supports the efforts of other employees in implementing solutions to problems.
Able to see issues from others' perspectives.
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
Recognizes and values individual and cultural differences.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Encourages a work environment where individual differences are valued.
Seeks out different viewpoints and benefits from different perspectives.
Respects others regardless of age, race, gender, nationality, or disability.
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
Attempts to persuade others rather than simply control them.
Develops a good rapport with others.
Has excellent influencing/negotiating skills.
Ensures stakeholders are involved in the decision making process.
Persuades others to consider alternative points of view.
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
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Works effectively in dynamic and changing work environments.
Able to work effectively with new people and new teams.
Develops insights and applies innovative solutions to projects and problems.
Is proactive and takes steps to prepare for changes in the workplace.
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
Takes ownership of mistakes and learns from them.
Develops goals and establishes objective measures of success.
Defines roles, rights, and responsibilities of employees.
Takes responsibility for results.
Defines roles, rights, and responsibilities of the team.
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
Prioritizes tasks to identify immediate and long-term objectives.
Keeps and maintains a To-Do list.
Leaves time in the schedule for unplanned contingencies.
Does not procrastinate.
Focuses on tasks that have high priority.
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.
Uses technology in decision making and problem solving.
Understands and is committed to implementing new technologies.
Maximizes the use of new technology to deliver products and services.
Adopts the implementation of new technology into the workplace.
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
Stays calm and focuses on the core issues to be discussed.
Identifies verbal and nonverbal cues to help interpret actions and messages.
Leverages relationships with others to achieve goals.
Able to say "no" when it is essential to maintaining quality and high standards.
Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
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.