Self-Management - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 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 5 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Self Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Uses patience and self-control in working with customers and associates.
Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Does not allow own emotions to interfere with the performance of others.
Steps away from a situation to process appropriate response.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?
Punctuality	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Arrives to meetings on time.
Avoids making personal phone calls during working hours.
Maintains an efficient schedule of activities.
Starts meetings on time.
Starts the workday when scheduled.
If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?
Attitude	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Contributes to a positive work environment.
Is gracious and professional in their interactions with others.
Shows by their actions that they trust in the positive intentions of others.
Treats all people fairly and with respect.
Visibly supports and encourages diversity in style and background.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.
Uses a scheduler/planner to keep tasks organized and on time.
Begins tasks as soon as possible.
Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
Is aware of the deadlines for specific tasks/assignments.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?
Objectives	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Communicates goals and objectives to employees.
Sets long-term and short-term goals.
Able to organize work.
Organizes and schedules events, activities, and resources.
Works toward achieving established goals and objectives.
If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?
Empowering Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Provides support and resources needed to accomplish goals.
Trusts employees are able to complete assigned tasks.
Assigns tasks that are within the skill levels of employees.
Willing to share in the decision making process.
Is confident in the abilities of employees assigned important tasks.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?
Others	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Respects the opinions of other employees.
Forms working relationships with employees from other departments.
Constructively receives criticism and suggestions from others.
Consistently demonstrates ability and willingness to trust others.
Works across boundaries within the organization.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?
Organizational Fluency	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Understands departmental policies and procedures.
Anticipates problems that may affect the department.
Able to explain departmental policies and procedures to others.
Effective in communicating with others within the organization.
Gets things done through the department.
If [Participant Name] were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?
Global Perspective	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Applies knowledge of overseas markets.
Works well with others from different cultural backgrounds.
Collaborates with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Builds working relationships with others across cultures.
If [Participant Name] were to make improvements in Global Perspective, 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.