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360 Feedback Survey Sample 4


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ABC Global 360-Degree Feedback


Rater:
You are providing feedback to:

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of our company’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.

Please provide feedback using the form below. If you are not able to respond to an item, leave it blank and go on to the next item. When you have finished, press the SAVE or COMPLETED button at the bottom of the form.

Note: When you enter text comments into the boxes below, please focus your comments on work behaviors and styles. The comments that you type will be viewed by the individual receiving the feedback. Do not enter personal information about yourself unless you want this individual to know you are the author of these comments.

To what extent does exhibit the following ...
Read the statements below. Please indicate the degree to which ____________ exhibits these behaviors.

Interpersonal

Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
cannot comment
  1. Treats employees with respect.
  1. Behaves in a fair and trustworthy manner.
  1. Handles tough employee issues fairly and effectively; works well to resolve conflicts.
  1. Handles job-related stress effectively (does not blame others, become hostile or overly moody); keeps in control of his/her feelings and behavior.
  1. Keeps employees informed of information they need to do their jobs.
  1. Receives both positive and negative feedback well.
Comments:

Leadership

Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
cannot comment
  1. Understands employees' needs.
  1. Provides the necessary training, guidance, and motivation to help employees meet and exceed their job responsibilities.
  1. Creates and open and trusting environment where people feel safe to discuss concerns, ideas, opinions.
  1. Provides appropriate recognition to employees for good performance.
  1. Sets and communicates clear performance expectations.
  1. Makes effective and timely decisions, even when data is limited or solutions produce unpleasant consequences.
  1. Inspires others by recognizing and rewarding people for their work.
  1. Creates a professional image that establishes and maintains credibility.
  1. Assesses current and future staffing needs based on organizational goals and budget realities. Using merit principles, ensures staff are appropriately selected, developed, utilized, appraised, and rewarded; takes corrective action.
Comments:

Results Orientation/
Leading Change

Clear Strength Capable and Effective Performance Could benefit from Development Needs Significant Improvement N/A,
cannot comment
  1. Embraces safety procedures and make employees accountable for working within safety policies; reports injuries and near-miss situations per policy; takes immediate action when unsafe acts are observed
  1. Holds all employees accountable for their results.
  1. Is positive and passionate about the division and its mission.
  1. Determines objectives and sets priorities; anticipates potential threats or opportunities
  1. Responds to workplace changes with flexibility and optimism.
Comments:


Comments

In the spaces provided below, please type in any comments/feedback about ______ that you believe are relevant to his/her development.

Recognize that your comments will be listed along with the comments from all other sources and provided to this employee. Do not record any information that will identify you as the source, unless you want this employee to know that you are the source of the comment.

Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.


Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.


Additional comments, if any: