Trustworthy - 360 Degree Feedback Survey Sample #8

Instructions

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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

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Trustworthy	Agree	Unsure	Disagree	N/A
Takes ownership, delivers on commitments
Builds and maintains the trust of others.
Is a person you can trust.
Delivers on promises made.
Takes care to maintain confidential information.
Adaptability	Agree	Unsure	Disagree	N/A
Integrates information from a variety of sources to develop new and creative solutions.
Adapts to novel, dynamic, and changing situations requiring creative solutions to new problems.
Recognizes when course changes are needed and takes appropriate action.
Able to adjust to changing environments.
Adapts to work successfully in a wide variety of situations and with a variety of coworkers.
Integrity	Agree	Unsure	Disagree	N/A
Is consistent in ethical behavior, demonstrating professionalism and a commitment to the company's values.
Creates a culture where employees feel the need to maintain high standards of integrity.
Inspires others to perform at their best by fostering a culture of integrity and achievement within the organization.
Accepts responsibility for production line downtime.
Leads by example, demonstrating a strong work ethic and commitment to excellence.
Management	Agree	Unsure	Disagree	N/A
Identifies key success drivers to align resource planning (and prioritization) with strategic objectives for competitive advantage.
Sets a high personal standard of productivity that inspires and elevates team performance.
Creates a safe and respectful environment where all parties feel heard and are encouraged to express concerns openly.
Openly admits errors and uses them as learning opportunities for self and team.
Encourages team members to take ownership of their work and hold each other accountable.
Initiative	Agree	Unsure	Disagree	N/A
Confronts problems immediately without supervisor instructions.
Builds strong interpersonal relationships upon first meeting.
Takes corrective action to rectify issues.
Takes the initiative to start work on new projects.
Expands the offerings of the department by working evenings and weekends.
Technical	Agree	Unsure	Disagree	N/A
Willingly shares information and expertise; sought out as resource by others
Seeks information from others as needed.
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Knows how to produce high quality products/work.
Is knowledgeable of procedures or systems necessary for the job.
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Honest about owning up to mistakes made.
Attends to both the content and the context of what was being said.
Values the opinions of others.
Comes across as credible, knowledgeable and sincere
Effectively manages conflicts by dealing with them directly and immediately
Responsible	Agree	Unsure	Disagree	N/A
Holds herself / himself accountable to goals / objectives
Sets a good example.
Behavior is ethical and honest.
Completes assigned work tasks.
Sets a good example
Coaching	Agree	Unsure	Disagree	N/A
Allocates specific time slots for coaching that are free from interruptions or urgent tasks.
Helps employees to maintain high personal standards.
Investigates the issues or hurdles that the employee may be encountering.
Helps individuals explore their strengths, aspirations, and areas for growth.
Has genuine empathy for the employee.
Others	Agree	Unsure	Disagree	N/A
...treats others with respect and dignity.
Includes others in the decision making processes.
Treats others with respect and dignity.
Forms working relationships with employees from other departments.
Supports the efforts of other employees in implementing solutions to problems.

51. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.