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
Is a person you can trust.
Sets high personal standards of performance.
Completes assigned work tasks.
Behavior is ethical and honest.
Holds herself / himself accountable to goals / objectives
Sets a good example.
Acts as a resource without removing individual responsibility.
Sets a good example
...takes personal responsibility for results.
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
Assesses employees' developmental needs.
Supports the successes of other employees.
Recognizes and celebrates accomplishments of others.
Is open to receiving feedback.
Sets performance objectives for subordinates that encourages development opportunities.
Encourages employees through recognition of positive changes in behavior.
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
Follows existing procedures and processes.
Expresses loyalty and dedication to [Company] in interactions with others.
Understands how decisions impact other business units beyond their immediate department of work group.
Attends [Company] gatherings and social events.
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
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
Sets an example for others to follow
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Is ready to offer help
Delegate tasks effectively
Takes responsibility for things that go wrong
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
Seeks innovative ways to change, grow, and improve the department.
Suggests new ideas at meetings.
Adequately funds innovation efforts to ensure their success.
Optimizes the innovation process by incorporating feedback and lessons learned from previous experiences.
Looks for new ways of doing things.
Seeks new ideas and adapts to changing environments.
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
Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
Applies complex rules and regulations to maintain optimal system performance.
Maximizes the use of new technology to deliver products and services.
Proficient in the use of technical systems and processes.
Understands and is committed to implementing new technologies.
Adopts the implementation of new technology into the workplace.
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
Responds quickly to inquiries from potential customers.
Adapts management style to meet the needs of the individual or situation.
Gives good advice and suggestions to coworkers.
Considers the other individual's point of view.
Assists those in the department who need help in meeting performance metrics.
Applies appropriate communication techniques to the situation.
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.