Trustworthy - 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

Trustworthy	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Builds and maintains the trust of others.
Consistently keeps commitments.
Takes ownership, delivers on commitments
Communicates an understanding of the other person's interests, needs and concerns.
Demonstrates congruence between statements and actions.
If were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Decision Making	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
Asks for additional information when making critical decisions.
Exercises good judgment by making sound and informed decisions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
If were to make improvements in Decision Making, what are your suggestions for how he/she can improve this?
Action	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Makes effective decisions, even when under pressure.
Drives and mobilizes others progress toward goals.
Motivates & supports others to gain skills
Works quickly when faced with difficult problems.
Gets the job done.
If were to make improvements in Action, what are your suggestions for how he/she can improve this?
Developing Others	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Encourages employees through recognition of positive changes in behavior.
Is open to receiving feedback.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Recognizes and celebrates accomplishments of others.
Assesses employees' developmental needs.
If were to make improvements in Developing Others, 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 current job responsibilities.
Looks for ways to improve work processes and procedures.
Open to the suggestions from others.
Promotes training and development opportunities to enhance job performance.
Looks for ways to expand and learn new job skills.
If were to make improvements in Continual Improvement, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Seeks feedback to enhance performance.
Looks to others for input.
Is visible and approachable.
Is easy to approach with ideas and opinions.
Asks others for their ideas and opinions.
If were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Attitude	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Visibly supports and encourages diversity in style and background.
Contributes to a positive and fun work environment.
Treats all people fairly and with respect.
Works to eliminate unnecessary work or barriers that get in others' way.
Builds open and trusting relationships.
If were to make improvements in Attitude, what are your suggestions for how he/she can improve this?
Performance	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Able to organize work.
Effective in performing his/her job.
...Overall Performance
Has great overall performance
Effectively organizes resources and plans
If were to make improvements in Performance, what are your suggestions for how he/she can improve this?
Problem Solving	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Works cooperatively with others to solve problems.
Able to balance the needs of different people in a solution to a problem.
Identifies and assesses all potential responses to a problem.
Ability to solve problems at root cause rather than at symptom level.
Effective in solving problems.
If were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?
Achievement	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Systematically works to improve the organization
Demonstrates a well-organized and timely approach to achieve desired results
Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
Accepts setbacks and challenges as improvement opportunities
Completes work to a high technical standard
If were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Regulatory/Compliance	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Performs audits regularly, or without notice, to ensure proper compliance with regulations.
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Ensures regulations are followed as required.
Addresses issues quickly before they develop into major problems.
Explains regulations and procedures to others as required.
If were to make improvements in Regulatory/Compliance, what are your suggestions for how he/she can improve this?
Business Acumen	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
Exhibits behavior that is consistent with the vision, mission, and core values of the organization
Applies the knowledge of work processes to influence the achievement of business goals
Asks the 'right' questions to size up or evaluate situations.
Understands complex issues and problems.
If were to make improvements in Business Acumen, what are your suggestions for how he/she can improve this?

61. What are 's greatest strengths demonstrated this year?
    
    
    
62. What are 's areas for development?
    
    
    
63. Please give any final comments or suggestions for 's assessment.