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
Acts as a resource without removing individual responsibility.
Holds herself / himself accountable to goals / objectives
...takes personal responsibility for results.
Sets a good example.
Is a person you can trust.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Is open and approachable
Addresses critical customer issues in a timely manner.
Easily approachable.
Is a committed and reliable partner.
Uses tact, compassion, and sensitivity in interactions with others.
Coaching	Agree	Unsure	Disagree	N/A
Helps employees to maintain high personal standards.
Conducts regular performance appraisals and feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Addresses employee behavior problems effectively.
Develops the skills and capabilities of others.
Flexibility	Agree	Unsure	Disagree	N/A
Performs more and varried processes on the production line.
Adapts to circumstances as needed.
Is flexible in considering different viewpoints.
Able to increase output to meet increased demand.
Adapts to new organizational structures, policies, or procedures.
Quality	Agree	Unsure	Disagree	N/A
Systematically and thoroughly inspects products for consistency in meeting specifications.
Assists quality control inspectors.
Maintains detailed instructions to ensure consistency and quality in the production line.
Is a role model for quality practices and standards.
Designs effective quality control systems.
Problem Solving	Agree	Unsure	Disagree	N/A
Effective in solving problems.
Actively seeks the root cause of a problem.
Identifies and assesses all potential responses to a problem.
Makes judgments based upon relevant information.
Generates alternative solutions to problems and challenges.
Results Oriented	Agree	Unsure	Disagree	N/A
Sets important goals for the department.
Creates measures of performance to track progress.
Is a high achiever.
Concentrates efforts on the most urgent needs.
Focuses on achieving important goals.
Others	Agree	Unsure	Disagree	N/A
Respects the opinions of other employees.
Treats others with respect and dignity.
Is able to see issues from others' perspectives.
Able to see issues from others' perspectives.
Constructively receives criticism and suggestions from others.
Global Perspective	Agree	Unsure	Disagree	N/A
Engages in problem solving with individuals outside of the country.
Demonstrates a curiosity about diverse individuals and cultures.
Analyzes global issues/problems that are having a large impact on the Company.
Understands how cultures differ and how these differences impact work behavior.
Communicates effectively on a multi-lingual basis.

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.