Responsibility - 360 Degree Feedback Survey Sample #8

Instructions

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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Responsible	Agree	Unsure	Disagree	N/A
Holds herself / himself accountable to goals / objectives
Sets a good example.
Responsible for setting the vision of the department.
Sets a good example
Acts as a resource without removing individual responsibility.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Builds a strong rapport with co-workers.
Demonstrates willingness to work with others.
Successfully resolves conflicts and grievances to a win-win solution.
Provides constructive feedback in a way that fosters acceptance and development.
Is a role model for others
Coaching	Agree	Unsure	Disagree	N/A
Conducts regular performance appraisals and feedback.
Helps employees to understand responsibilities, authority, and expectations.
Addresses employee behavior problems effectively.
Helps employees to maintain high personal standards.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Flexibility	Agree	Unsure	Disagree	N/A
Able to adapt to new situations.
Acts decisively in frequently changing and uncertain environment.
Willing to try new ideas.
Adapts to new organizational structures, policies, or procedures.
Effective in incorporating new ideas.
Quality	Agree	Unsure	Disagree	N/A
Analyze what occurred and re-adjusts accordingly when goals are not met.
Always strives to produce the highest quality work products.
Reflects on what is working and what could be improved.
Encourages others to achieve high quality standards.
Encourages employees to produce the best quality products.
Problem Solving	Agree	Unsure	Disagree	N/A
Generates alternative solutions to problems and challenges.
Actively seeks the root cause of a problem.
Solves problems using logic and insight.
Ability to develop innovative solutions to problems.
Able to balance the needs of different people in a solution to a problem.
Results Oriented	Agree	Unsure	Disagree	N/A
Explains the "whys" behind organizational objectives
Directs team in prioritizing daily work activities
Stays focused on meeting the needs of customers.
Helps others when free-time is available.
Does not become distracted by non-issues or interruptions.
Others	Agree	Unsure	Disagree	N/A
Treats others with respect and dignity.
...treats others with respect and dignity.
Able to see issues from others' perspectives.
Includes others in the decision making processes.
Works effectively with people from other departments.
Global Perspective	Agree	Unsure	Disagree	N/A
Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
Aligns personal vision with global strategies.
Able to listen and understand others and discuss issues in a respectful way.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Can effectively deliver presentations to international clients.

46. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
47. Strengths
    
    
    
48. Areas for Development
    
    
    
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.