Self-Management - 360 Degree Feedback Survey Sample #1

Instructions:

The is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between and . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Self Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Steps away from a situation to process appropriate response.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Uses patience and self-control in working with customers and associates.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
If were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Continual Improvement	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Looks for ways to expand and learn new job skills.
Looks for ways to improve work processes and procedures.
Looks for ways to expand current job responsibilities.
Promotes training and development opportunities to enhance job performance.
Open to the suggestions from others.
If were to make improvements in Continual Improvement, what are your suggestions for how he/she can improve this?
Emotional Intelligence	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Is able to control their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to manage their own emotions.
Is able to express themselves clearly.
Accurately perceives the emotional reactions of others.
If were to make improvements in Emotional Intelligence, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
Works effectively in dynamic and changing work environments.
Recognizes and implements changes to enhance efficiency and effectiveness.
Develops insights and applies innovative solutions to projects and problems.
Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
If were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Bias for Action	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Completes work on time
Encourages risk taking and experimentation to improve performance
Seeks and utilizes opportunities for continuous learning and self-development.
Displays high energy and enthusiasm on consistent basis.
If were to make improvements in Bias for Action, what are your suggestions for how he/she can improve this?
Supervisory Skills	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Promotes teamwork and cooperation within the department.
Provides constructive, ongoing feedback.
Appropriately recognizes and rewards employees.
Resolves personnel problems quickly and effectively.
Is aware of the unique strengths of each employee.
If were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?
Quality	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Encourages others to produce the highest quality work products.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Encourages employees to produce the best quality products.
Holds employees accountable for their quality of work.
Corrects issues in a timely manner.
If were to make improvements in Quality, what are your suggestions for how he/she can improve this?
Time Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Does not procrastinate.
Prioritizes new tasks according to their relative importance.
Sets a good balance between work and family life.
Deals effectively with interruptions.
Focuses on tasks that have high priority.
If were to make improvements in Time Management, what are your suggestions for how he/she can improve this?
Commitment To Result	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
Takes immediate action toward goals.
Committed to the team.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Encourages commitment in others to obtain results.
If were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?
Technology Use/Management	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Uses technology in decision making and problem solving.
Supports employee training and development initiatives regarding implementation of technology.
Maximizes the use of new technology to deliver products and services.
Proficient in the use of technical systems and processes.
Adopts the implementation of new technology into the workplace.
If were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?
Managing Risk	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
Seeks to retain the best and brightest employees.
Bases decisions on patterns found in fluid/changing information.
Recognizes that small changes may snowball into major events.
Responds appropriately to unexplained or unanticipated events.
If were to make improvements in Managing Risk, what are your suggestions for how he/she can improve this?
Responsible	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Sets a good example
Behavior is ethical and honest.
Acts as a resource without removing individual responsibility.
Sets a good example.
...takes personal responsibility for results.
If were to make improvements in Responsible, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Encourages employees to solve problems on their own.
Sets clear goals for others to accomplish.
Distributes the workload to subordinates.
Provides support and resources needed to accomplish goals.
Encourages others to obtain necessary skills and training.
If were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Others	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Treats others with respect and dignity.
Able to see issues from others' perspectives.
Respects the opinions of other employees.
Is able to see issues from others' perspectives.
...treats others with respect and dignity.
If were to make improvements in Others, what are your suggestions for how he/she can improve this?
Planning	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Able to identify the needs of the department before a major change.
Delegates role to team members to accomplish goals.
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Makes plans and follows through.
Anticipates obstacles and ways to overcome them.
If were to make improvements in Planning, what are your suggestions for how he/she can improve this?

76. What are 's greatest strengths demonstrated this year?
    
    
    
77. What are 's areas for development?
    
    
    
78. Please give any final comments or suggestions for 's assessment.