Responsibility- 360 Degree Feedback Survey Sample #1

Instructions:

The is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between and . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Responsible	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Behavior is ethical and honest.
Works in a way that makes others want to work with her/him.
Holds herself / himself accountable to goals / objectives
Sets high personal standards of performance.
Acts as a resource without removing individual responsibility.
If were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Bias for Action	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Identifies ways to simplify work processes and reduce cycle times
Completes work on time
Seeks and utilizes opportunities for continuous learning and self-development.
Encourages risk taking and experimentation to improve performance
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
If were to make improvements in Bias for Action, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Actively seeks feedback from others.
Open to the suggestions of others.
Accepts the views of others.
Looks to others for input.
Shares past experiences with others as learning opportunities.
If were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Leadership	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Able to influence others.
Effectively leads others.
Demonstrates leadership and courage in critical situations.
Gives direct, constructive, and actionable feedback.
Acts decisively in implementing decisions.
If were to make improvements in Leadership, what are your suggestions for how he/she can improve this?
Performance	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Sets a high standard for job performance.
...Overall Performance
Effectively organizes resources and plans
Able to organize work.
Listens and responds to issues and problems
If were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Communication Skills	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Is an effective communicator
Able to demonstrate persuasiveness in pursuit of objectives.
Addresses issues of key importance to stakeholders.
Checks for understanding throughout conversations or group presentations/discussions
Communicates effectively with all levels of the organization.
If were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?
Decision Making	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
Is able to make decisions quickly.
Seeks input from key people who should be involved in, or will be affected by, decisions
Exercises good judgment by making sound and informed decisions.
Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
If were to make improvements in Decision Making, what are your suggestions for how he/she can improve this?
Change Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Assists others in understanding changes to the organization.
Adopts changes to set and example for others to follow.
Addresses organizational and departmental resistance to changes.
Supports the Company's efforts to implement changes.
Supports new initiatives for organizational changes to improve effectiveness.
If were to make improvements in Change Management, what are your suggestions for how he/she can improve this?
Business Acumen	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Considers impact of actions on other areas of the organization.
Applies the knowledge of work processes to influence the achievement of business goals
Understands complex issues and problems.
Exhibits behavior that is consistent with the vision, mission, and core values of the organization
Asks the 'right' questions to size up or evaluate situations.
If were to make improvements in Business Acumen, what are your suggestions for how he/she can improve this?
Organizational Fluency	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Able to explain departmental policies and procedures to others.
Anticipates problems that may affect the department.
Able to use corporate politics to advance department objectives.
Understands departmental policies and procedures.
Able to deal with sensitive issues with tact and professionalism.
If were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?

51. What are 's greatest strengths demonstrated this year?
    
    
    
52. What are 's areas for development?
    
    
    
53. Please give any final comments or suggestions for 's assessment.