Performance - 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 .

Performance	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Effectively organizes resources and plans
Sets a high standard for job performance.
Works effectively in the department.
Listens and responds to issues and problems
Able to organize work.
If [Participant Name] 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
Completes assigned work tasks.
Works in a way that makes others want to work with her/him.
...takes personal responsibility for results.
Holds herself / himself accountable to goals / objectives
Is a person you can trust.
If [Participant Name] 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
Gives employees the opportunity to make their own decisions at work.
Is aware of the skill levels of employees and assigns tasks that are at the appropriate skill level.
Allows the employees to have flexible work schedules.
Is confident in the abilities of employees assigned important tasks.
Distributes the workload to subordinates.
If [Participant Name] 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
Creates the conditions for partnerships to grow and develop.
Maintains infrastructure to support partnerships and networks.
Supports and encourages relationships that are created by diverse team members.
Collaborates with others to accomplish goals and objectives.
Creates value within the Company by building networks.
If [Participant Name] 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
Seeks and listens to other's contributions
Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
Encourages teamwork and collaboration.
Comes across as a reliable, committed team member
Communicates well with team members.
If [Participant Name] 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
Includes others in the decision making processes.
Respects the opinions of other employees.
Works effectively with people from other departments.
Constructively receives criticism and suggestions from others.
Forms working relationships with employees from other departments.
If [Participant Name] 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
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Understands the "basics" as to how [Company] functions/operates.
Understands how decisions impact other business units beyond their immediate department of work group.
Follows existing procedures and processes.
If [Participant Name] 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 [Participant Name Here]'s assessment.