Responsibility - 360 Degree Feedback Survey Sample #13

Instructions

You have been selected to provide valuable feedback for the manager listed above. Your insights are an important part of [Participant]'s leadership development process. This tool is designed to gather broad and comprehensive feedback on the core competencies and role responsibilities that are crucial for the continuous success of our organization.

When responding to the assessment form, please consider your experiences working with this individual over the past six to twelve months. Reflect on specific instances, interactions, and overall performance that you have observed. Your responses will be combined with feedback from other colleagues to create a holistic view of the manager's strengths and areas for improvement. This collective feedback will be used to guide their ongoing professional development.

Please be candid and constructive in your comments, as they will be shared anonymously with the manager. Your feedback will be instrumental in helping them understand their impact on the team and the organization, and in identifying opportunities for growth. We appreciate your time and effort in contributing to this important process.

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.



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Responsible	Strongly Disagree	Disagree	Agree	Strongly Agree
Sets a good example
Sets a good example.
...takes personal responsibility for results.
Behavior is ethical and honest.
Holds herself / himself accountable to goals / objectives
Completes assigned work tasks.
Acts as a resource without removing individual responsibility.
Sets high personal standards of performance.
Responsible for setting the vision of the department.
Interpersonal Skills	Strongly Disagree	Disagree	Agree	Strongly Agree
Anticipates the concerns of other employees.
Is willing to lend a hand to those in the department who need help.
Gives good advice and suggestions to coworkers.
Respects other members of the team/department.
Is someone you can trust.
Collaboration	Strongly Disagree	Disagree	Agree	Strongly Agree
Includes all stakeholders in the decision making process.
Is a trustworthy and credible partner.
Displays a high degree of trust and credibility.
Is a dependable partner in the group.
Willing to work with others to solve problems.
Partnering/Networking	Strongly Disagree	Disagree	Agree	Strongly Agree
Strengthens the contacts with other departments.
Facilitates open and honest communication to build trust and mutual respect.
Uses informal networks to share information.
Contacts possible partners to seek new opportunities.
Can easily explain the foundations (justification) for the partnership.
Recognition	Strongly Disagree	Disagree	Agree	Strongly Agree
Offers recognition in a timely manner.
Says "thank you" to show appreciation for work of others.
Recognizes team members who offer a significant contribution to a project.
Compliments other people when they do good work
Makes people around them feel appreciated and valued.
Others	Strongly Disagree	Disagree	Agree	Strongly Agree
Consistently demonstrates ability and willingness to trust others.
Is able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Respects the opinions of other employees.
Able to see issues from others' perspectives.
Problem Solving	Strongly Disagree	Disagree	Agree	Strongly Agree
Measures the solution's impact on the desired outcomes and identifyies any deviations from the expected performance.
Bounces back from setbacks and learn from failures, adapting and adjusting approaches as needed.
Assigns individuals the responsibility for completing separate phases of the implementation.
Generates a wide range of possible solutions.
Establishes a timeline for implementation and organizes the needed supplies and equipment.
Results Oriented	Strongly Disagree	Disagree	Agree	Strongly Agree
Establishes benchmarks to be met when working on projects.
Is considered a high achiever.
Makes sure employees have the resources they need to achieve their results.
Keeps track of progress toward the results.
Encourages a high-energy, fun work environment and coaches others on how to do the same

45. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
46. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
47. Overall, please rate the effectiveness of [Participant Name Here].
    

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

    
    
    
48. Please give any final comments or suggestions for [Participant Name Here]'s assessment.