Teamwork- 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 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Teamwork	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Listens to other team members without interrupting them.
Shares pertinent information with all members of the team.
Encourages dialog between team members.
Makes eye contact when listening to colleagues.
Facilitates good rapport between team members.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?
Flexibility	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Adapts to circumstances as needed.
Works effectively during periods of change.
Effective in incorporating new ideas.
Able to adapt to new situations.
Identifies new opportunities to achieve goals
If [Participant Name] were to make improvements in Flexibility, what are your suggestions for how he/she can improve this?
Adaptability	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Adjusts tactics and strategies.
Able to adjust to changing environments.
Adjusts priorities to changing business goals.
Adjusts plans as needed based on changing conditions.
Embraces change and fosters an open-minded environment.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Asks others for their ideas and opinions.
Is easy to approach with ideas and opinions.
Open to the suggestions of others.
Is visible and approachable.
Seeks feedback to enhance performance.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Cultural Awareness	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Develops skills and attitudes to bridge cultural differences.
Accepts individual differences.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Aware of their own cultural views.
Helps other employees to become more culturally sensitive.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?
Supervisory Skills	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Provides training on equipment as needed.
Leads others through their commitment to the department.
Maintains the confidence and trust of employees.
Seeks to enhance the performance of employees under their supervision.
Asks employees for their input in decisions that may directly affect the team.
If [Participant Name] were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?
Time Management	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Reacts promptly to inquiries from customers/clients.
Gives undivided attention to tasks currently being worked on.
Delegates simple tasks to employees so the manager can focus on more complex tasks.
Is committed to finishing the most important tasks.
Manages inbox items promptly.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?
Safety	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Encourages others to work safely.
Develops a sustainable safety culture.
Participates in safety training when offered.
Develops a culture of safety.
Develops safety guidelines for the department.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

41. Strengths
    
    
    
42. Areas for Development
    
    
    
43. Please give any final comments or suggestions for [Participant Name Here]'s assessment.