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 .

Trustworthy	Agree	Unsure	Disagree	N/A
Demonstrates a sense of responsibility and commitment to public trust.
Delivers on promises made.
Is trustworthy; is someone I can trust.
Consistently keeps commitments.
Is a person you can trust.
Adaptability	Agree	Unsure	Disagree	N/A
Accommodates changes as needed.
Is open to change and adjusts plans when needed.
Able to adapt to changes in technology and processes.
Responsive to the needs of others.
Learns from personal experiences and/or mistakes.
Integrity	Agree	Unsure	Disagree	N/A
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Demonstrates honesty and truthfulness at all times.
Fosters an environment built upon trust.
Follows tasks to completion.
Management	Agree	Unsure	Disagree	N/A
Makes you feel enthusiastic about your work
Takes responsibility for things that go wrong
Delegate tasks effectively
Sets an example for others to follow
Keep staff informed about what is happening in the company
Initiative	Agree	Unsure	Disagree	N/A
Prepares for unexpected contingencies.
Will continue to work on a problem even in the face of obstacles.
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Looks to start work on new projects without waiting for direction from the manager.
Anticipates problems and initiates plans to address them.
Technical	Agree	Unsure	Disagree	N/A
Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
Knows how to produce high quality products/work.
Seeks information from others as needed.
Demonstrates mastery of the technical competencies required in his/her work.
Willingly shares his/her technical expertise; sought out as resource by others
Interpersonal Skills	Agree	Unsure	Disagree	N/A
Gives credit where credit is due.
Is a highly respected individual in the company.
Successfully resolves conflicts and grievances to a win-win solution.
Communicates initiatives in a clear and actionable manner to employees.
Applies appropriate communication techniques to the situation.
Responsible	Agree	Unsure	Disagree	N/A
Works in a way that makes others want to work with her/him.
Behavior is ethical and honest.
...takes personal responsibility for results.
Sets a good example
Acts as a resource without removing individual responsibility.
Coaching	Agree	Unsure	Disagree	N/A
Helps employees to maintain high personal standards.
Addresses employee behavior problems effectively.
Provides clear, motivating, and constructive feedback.
Develops the skills and capabilities of others.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Others	Agree	Unsure	Disagree	N/A
Includes others in the decision making processes.
Works effectively with people from other departments.
Respects the opinions of other employees.
Is able to see issues from others' perspectives.
Able to see issues from others' perspectives.

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.