Responsibility - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

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 .

Responsible	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Behavior is ethical and honest.
Responsible for setting the vision of the department.
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.
Sets a good example
Acts as a resource without removing individual responsibility.
Sets a good example.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Provides constructive feedback to others.
Sets performance objectives for subordinates that encourages development opportunities.
Supports the successes of other employees.
Creates a work environment that fosters positive feedback to employees.
Encourages employees through recognition of positive changes in behavior.
Assesses employees' developmental needs.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?
Company	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Impresses upon others the important aspects of [Company].
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands the use of [Company] products and services.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?
Management	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Keep staff informed about what is happening in the company
Is ready to offer help
Takes responsibility for things that go wrong
Makes you feel enthusiastic about your work
Sets an example for others to follow
Delegate tasks effectively
If [Participant Name] were to make improvements in Management, what are your suggestions for how he/she can improve this?
Innovation	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Offers constructive improvements to existing systems.
Creates new and imaginative approaches to work-related issues.
Provides incentives for employees who contribute innovative ideas and successfully implement them.
Develops several approaches or solutions to a problem.
Facilitates networking events or brainstorming sessions where employees can share insights and inspirations.
Encourages employees to consider opportunities to innovate processes and products.
If [Participant Name] were to make improvements in Innovation, what are your suggestions for how he/she can improve this?
Technology Use/Management	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Adopts the implementation of new technology into the workplace.
Uses technology in decision making and problem solving.
Maximizes the use of new technology to deliver products and services.
Applies complex rules and regulations to maintain optimal system performance.
Supports technical training and development of employees.
Proficient in the use of technical systems and processes.
If [Participant Name] were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?
Interpersonal Skills	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Considers the other individual's point of view.
Demonstrates positive behaviors for others to follow.
Takes time to recognize the efforts of others.
Values the opinions of others.
Pays close attention to what is being communicated verbally and nonverbally.
Promotes acceptance of diverse viewpoints from team members.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?

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