Initiative - 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 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.



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Initiative	Agree	Unsure	Disagree	N/A
Expands the offerings of the department by working evenings and weekends.
Acts with urgency when time is of the essence.
Anticipates problems and initiates plans to address them.
Takes corrective action to address performance deficiencies/issues.
Does the right thing without being told.
Change Management	Agree	Unsure	Disagree	N/A
Understands the consequences that may result from significant changes.
Modifies leadership style to address new challenges.
Adjusts leadership approach to align with evolving circumstances.
Is aware of changes in customer needs/demands.
Effectively manages change in a dynamic business environment.
Flexibility	Agree	Unsure	Disagree	N/A
Performs more and varried processes on the production line.
Encourages a culture of experimentation and innovation.
Is flexible in solving difficult problems.
Able to adapt to new situations.
Capable of adapting workflows to accommodate new regulations or policies.
Bias for Action	Agree	Unsure	Disagree	N/A
Reduces interruptions and stay focused on their objectives.
Overcomes obstacles to strengthen resilience and determination, becoming more capable of handling future challenges.
Positively motivates and supports others to gain skills
Projects a can-do attitude that, within the department, is contagious.
Initiates tasks or projects that address identified needs.
Self Management	Agree	Unsure	Disagree	N/A
Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Uses patience and self-control in working with customers and associates.
Does not allow own emotions to interfere with the performance of others.
Steps away from a situation to process appropriate response.
Continual Learning	Agree	Unsure	Disagree	N/A
Shares best practices with others and learns from others.
Participates in regular training offered.
Pursues self-improvement through continual learning.
Sets relevant learning objectives and goals.
Pursues learning that will enhance job performance.
Feedback	Agree	Unsure	Disagree	N/A
Takes steps to prevent retaliation against feedback givers.
Consistently reviews work achievements in relation to defined goals and criteria, recognizing areas for potential improvement.
Is open to receiving insights from others about their strengths and areas needing development.
Ensures that any concerns raised through feedback are resolved.
Helps employees transform their feedback results into practical steps.
Technical	Agree	Unsure	Disagree	N/A
Willingly shares information and expertise; sought out as resource by others
Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Demonstrates mastery of the technical competencies required in his/her work.
Is knowledgeable of procedures or systems necessary for the job.
Willingly shares his/her technical expertise; sought out as resource by others
Objectives	Agree	Unsure	Disagree	N/A
Works toward achieving established goals and objectives.
Consistently provides me with timely feedback for improving my performance.
Encourages me to take on greater responsibility.
Sets long-term and short-term goals.
Ability to establish realistic goals.
Responsible	Agree	Unsure	Disagree	N/A
Sets a good example.
Acts as a resource without removing individual responsibility.
Completes assigned work tasks.
Is a person you can trust.
Holds herself / himself accountable to goals / objectives
Partnering/Networking	Agree	Unsure	Disagree	N/A
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Forms strategic partnerships and business alliances to expand opportunities.
Builds alliances with others in the company.
Develops trust in others to form partnerships and networks.
Establishes clear expectations at the start of a new partnership.
Strategic Focus	Agree	Unsure	Disagree	N/A
Identifies sources for developing a global competitive advantage for the company.
Detects changes in the environment and updates the strategic plan to address new opportunities or threats.
Strategically focuses efforts to improve operational efficiencies.
Develops an organizational strategy for each functional area within the mission statement.
Modifies strategic decisions depending on changes in the business environment.

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

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

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.