Performance - 360 Degree Feedback Survey Sample #7

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 and .

Performance	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Works well in this position.
Works effectively in the department.
Shown significant improvement in job performance.
Effectively organizes resources and plans
Effective in performing his/her job.
If were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Responsible	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
...takes personal responsibility for results.
Works in a way that makes others want to work with her/him.
Is a person you can trust.
Sets a good example
Sets a good example.
If were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages others to obtain necessary skills and training.
Avoids micromanaging their employees.
Encourages employees to solve problems on their own.
Sets clear goals for others to accomplish.
Distributes the workload to subordinates.
If were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Partnering/Networking	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Partners with peers to obtain influence within the Company.
Supports and encourages relationships that are created by diverse team members.
Promotes the understanding of how the department affects the organization overall.
Creates the conditions for partnerships to grow and develop.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
If were to make improvements in Partnering/Networking, what are your suggestions for how he/she can improve this?
Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages collaboration with other departments.
Works cooperatively with others to solve problems.
Effective team player
Act as an effective team player
Applies knowledge of team behavior to help achieve organizational goals and objectives.
If were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Able to see issues from others' perspectives.
Works effectively with people from other departments.
Helpful
Works across boundaries within the organization.
Respects the opinions of other employees.
If were to make improvements in Others, what are your suggestions for how he/she can improve this?
Company	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Follows existing procedures and processes.
Attends [Company] gatherings and social events.
Impresses upon others the important aspects of [Company].
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.
If were to make improvements in Company, what are your suggestions for how he/she can improve this?

36. Strengths
    
    
    
37. Areas for Development
    
    
    
38. Please give any final comments or suggestions for 's assessment.