Confidential (Other) Form

Contact REB-Co. before submitting this form. You must be issued a valid Employee ID

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     Participant:

Participant ID: NOTE! Approved Participant ID required.
For more information contact R.E.B. - Co. or (510) 234 8800

Your relationship to the Participant: Manager of Participant Peer Direct Report Other

(If Other, please indicate; customer, spouse, partner, board member, etc.)

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The person named above is participating in a unique management development program which is tailored to the individual's specific management interests and needs. The purpose of this questionnaire is to assist the participant to gain insights to the perceptions of the participant's management effectiveness. By answering these questions candidly, you will contribute greatly to the value of the program. We cannot over-emphasize the potential value of the comments you are providing. Thank you for taking time to answer the following questions frankly and constructively.

In Items 5-12, in addition to the narratives requested, please indicate the number rating (1,2,3,4, or 5) which, in your opinion, best describes the participant's performance in the skill area indicated.

1 = poor 2 = fair 3 = average 4 = good 5 = excellent

Please use "average" as little as possible.

 

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I. In what aspects of management does the participant excel?

 

II. In what aspects of management could the participant be more effective?

 

III. What is the participant's key management improvement opportunity?

 

IV. What are two of the participant's major short term business goals?
a.

 

b.

Individual skills in all key management functions continually need review and refinement in order to be optimally effective. Please identify specific areas which, if strengthened, could assist the participant in becoming more effective:

V. Communicating (creating understanding within yourself and others)

1. Giving clear, concise oral directions and explanations	1 2 3 4 5
2. Communicating in writing clearly and concisely	1 2 3 4 5
3. Clearly defining expected results	1 2 3 4 5
4. Listening with concentration	1 2 3 4 5
5. Encouraging feedback	1 2 3 4 5
6. Keeping others informed	1 2 3 4 5
7. Handling conflict effectively	1 2 3 4 5
8. Sensitive to non-verbal cues	1 2 3 4 5
9. Demonstrating respect for other points of view	1 2 3 4 5

Please describe a challenging incident that occurred in the last two or three months in which the participant communicated effectively with someone in their work group (e.g. by giving clear direction, writing, listening, encouraging feedback and participation, understanding, or handling conflict.)

VI. Planning (defining goals, selecting strategies, and developing action plans)

10. Foreseeing problems and opportunities	1 2 3 4 5
11. Analyzing situations	1 2 3 4 5
12. Developing direction including vision, missions, strategies	1 2 3 4 5
13. Ensuring the work to be done is identified, scheduled	1 2 3 4 5
14. Leading in planning performance standards	1 2 3 4 5
15. Participatively setting goals / objectives	1 2 3 4 5
16. Developing practical action plans	1 2 3 4 5
17. Making sure priorities are set	1 2 3 4 5

Please describe an incident during the last two or three months in which the participant clearly conveyed to team members a sense of the company's vision and plans, (e.g. creating a vision, defining expectations, setting direction including goals/objectives, prioritizing, action planning, allocating resources.)

VII. Organizing (grouping tasks and resources to achieve goals)

18. Structuring the work	1 2 3 4 5
19. Obtaining and utilizing resources	1 2 3 4 5
20. Structuring relationships	1 2 3 4 5
21. Establishing clear roles and authority	1 2 3 4 5
22. Integrating related activities	1 2 3 4 5
23. Sorting the vital from less important	1 2 3 4 5
24. Delegating work and authority	1 2 3 4 5
25. Managing time effectively	1 2 3 4 5

Please describe an incident in which the participant encouraged others to do their best. (e.g. by arranging and relating work, clarifying authority/responsibility, empowering others, delegating, utilizing time and other resources efficiently.)

VIII. Staffing (retaining, recruiting, selecting, and training personnel)

26. Defining competencies and needs	1 2 3 4 5
27. Selecting, interviewing	1 2 3 4 5
28. Training	1 2 3 4 5
29. Coaching, mentoring, developing	1 2 3 4 5
30. Facilitating development	1 2 3 4 5
31. Encouraging continuous learning	1 2 3 4 5
32. Appraising performance	1 2 3 4 5
33. Resolving performance issues	1 2 3 4 5
34. Recognizing and rewarding performance	1 2 3 4 5

Please think of something that the participant did during the past two or three months which you believe effectively supported the personal and professional development of the staff members or co-workers, (e.g. by selecting, developing, coaching, reviewing performance, appraising competencies, effectiveness with people.)

IX. Controlling (monitoring results, comparing against plan, and taking responsive actions)

35. Measuring and evaluating results	1 2 3 4 5
36. Gathering performance data	1 2 3 4 5
37. Meeting regularly with individual team members for review	1 2 3 4 5
38. Discussing action required	1 2 3 4 5
39. Following through to completion	1 2 3 4 5
40. Reinforcing positive performance	1 2 3 4 5
41. Encouraging self-control	1 2 3 4 5
42. Facilitating continuous improvement	1 2 3 4 5

Please think of something that the participant did during the past two or three months which was effective in setting standards, monitoring progress, encouraging innovation, meeting regularly with team members, taking corrective action, following through, making a major improvment.

X. Leadership (creating individual and team motivation to achieve goals)

43. Demonstrating self-confidence	1 2 3 4 5
44. Taking charge/initiating action	1 2 3 4 5
45. Creating enthusiasm for vision and direction	1 2 3 4 5
46. Empowering others to act	1 2 3 4 5
47. Demonstrating decisiveness	1 2 3 4 5
48. Modeling competencies	1 2 3 4 5
49. Accepting input, finding better ways	1 2 3 4 5
50. Creating climate for motivation	1 2 3 4 5
51. Accepting the risks	1 2 3 4 5
52. Generating enthusiasm	1 2 3 4 5
53. Encouraging and facilitating teamwork	1 2 3 4 5
54. Understanding people	1 2 3 4 5

Please think of something that the participant did during the past two or three months which effectively got others wanting to do something the participant was convinced should be done, (e.g. by being decisive, taking charge, influencing and encouraging others, building and supporting teamwork, modeling desired competency with integrity, establishing a supportive culture.)

XI. Decision Making (selecting best solutions)

55. Analyzing issues and information	1 2 3 4 5
56. Maintaining objectivity	1 2 3 4 5
57. Openness to others' input	1 2 3 4 5
58. Applying creativity	1 2 3 4 5
59. Making decisions in timely manner	1 2 3 4 5

 

Please think of a decision the participant made during the past two or three months which used effective decision making to select the best solutions.

XII. Teamwork (working together to achieve common goals)

60. Demonstrating willingness to be a team member	1 2 3 4 5
61. Committing to total team goals	1 2 3 4 5
62. Giving support to other teams' goals	1 2 3 4 5
63. Coordinating with others to achieve goals	1 2 3 4 5
64. Supporting team process	1 2 3 4 5

a) Please describe your feelings about an incident during the last two or three months in which the participant demonstrated a desire to build a strong sense of effective teamwork.

b) Please describe your feelings about an incident in which the participant gave recognition for an employee's contribution to the team effort.

 

XIII. Any suggestions or comments?

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All of your responses will be held in the strictest confidentiality

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