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 .

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Responsible	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Acts as a resource without removing individual responsibility.
Holds herself / himself accountable to goals / objectives
Sets a good example.
Works in a way that makes others want to work with her/him.
Responsible for setting the vision of the department.
Completes assigned work tasks.
...takes personal responsibility for results.
Is a person you can trust.
Behavior is ethical and honest.
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
Creates a work environment that fosters positive feedback to employees.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Is open to receiving feedback.
Supports the successes of other employees.
Assigns tasks and responsibilities to develop skills of others.
Creates opportunities for professional development.
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
Helps employee satisfaction by reminding employees of how their work contributes to the shared goals and long-term success of the company.
Ensures employees have all the tools and equipment needed to maintain production schedules.
Treats mistakes as learning opportunities, not punishable offenses.
Establishes a Leave and Time Off policy to help improve work/life balance.
Aims to cultivate a team culture where people genuinely enjoy showing up and contributing.
Supports [Company]'s strategic objectives.
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
Anticipates potential obstacles and develops contingency plans to minimize disruption.
Is confident in the abilities of their subordinates.
Demonstrates dedication to team success by contributing beyond formal responsibilities when needed.
Develops contingency strategies to prepare for multiple future scenarios and uncertainties.
Supports employees in taking thoughtful risks and learning from outcomes, even when results are imperfect.
Communicates with clarity and confidence across all levels of the organization.
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
Fosters a culture of disruptive innovation to drive significant market shifts and create unparalleled value for customers.
Improves on ideas of others.
Identifies fresh approaches to solving problems.
Cultivates a culture of open communication where all ideas, no matter how unconventional, are welcomed and valued.
Encourages a search for radical innovation opportunities to obtain major breakthroughs.
Refines and tailors innovative concepts to better align with strategic objectives and market demands.
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
Supports technical training and development of employees.
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Understands and is committed to implementing new technologies.
Maximizes the use of new technology to deliver products and services.
Supports employee training and development initiatives regarding implementation of technology.
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
Gives credit where credit is due.
Is a role model for others demonstrating the importance of interpersonal skills.
Is open and approachable
Is a committed and reliable partner.
Embraces the differences in individuals that comprise the team.
Demonstrates compassion and understanding of others.
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.