360 Degree Feedback Form - Team Leader

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360 Degree Feedback Form - Team Leader This form is to provide 360 degree feedback to the Team Leader, [name] on areas critical to the success of ClASS. This form will be filled by the ClASS team members and leader (including self-review) who were in [country] for the trip ending [date]. It is important that you provide thoughtful and candid feedback supported by specific examples. This feedback is anonymous and is automatically summarized. The program manager will share this summary with the grantor Project Officer as needed for purposes of individual reviewer/ leader/officer development. Question 1. What is your role in ClASS? Grantor member Team Leader Team member (and NOT team leader) Other: Question 2. What is the name of the team leader for your group? Limit response to 150 characters. Question 3. How many days did you interact with the team leader? If you are the team leader, choose 'everyday'. Everyday Half or more days of their visit More than a quarter but less than half of their visit Less than a quarter of their visit Other:

Question 4. Overall, how would you evaluate the leadership/guidance provided by the team leader? Outstanding Excellent Good Average Poor know COMPETENCY DOMAIN I: LEADERSHIP Competency: Demonstrates sound leadership skills and behavior that fosters an environment of trust with the team, international partner, local grantee, and local clinical sites. Question 5. How strong is the team leader on each of the following attributes?: Adheres to legal and regulatory standards Develops external relationships Champions solutions and encourage decision making Fosters an environment of mutual trust Considers impacts and consequences of decision making in situations both internal and external Anticipates and plans strategies for overcoming obstacles Strong Proficient

Strong Proficient Promotes continuous organizational learning/improvement Lead and provide support/guidance to consultant reviewers Able to answer reviewer questions and provide guidance Provides appropriate feedback to reviewers that helped the assessment go smoothly. Checks-in with team members to confirm status of the review on a daily basis. Identifies those issues that required handling in a sensitive manner. Question 6. Additional Comments: Limit response to 300 characters. 300 characters remaining

COMPETENCY DOMAIN II: ORGANIZATIONAL CLIMATE & CULTURE Competency: Promotes organizational vision, values, and ethos. Question 7. How strong is the team leader on each of the following attributes?: Strong Proficient Develops effective relationships in support of the organization s mission, vision and strategic plan Encourage a high level of commitment to the purpose and values of the organization Hold self and others accountable for organizational goal attainment Delivers a clear overview of the ClASS process and review expectations in the entrance conferences Gain client s buy-in to accept risk and support new approaches Encourages teamwork Values and supports diversity

Question 8. Additional Comments: Limit response to 300 characters. 300 characters remaining COMPETENCY DOMAIN III: ORGANIZATION AND COORDINATION Competency: Demonstrates organizational and coordination skills Question 9. How strong is the team leader on each of the following attributes?: Coordinate/confirm daily logistics for team as needed Facilitates meetings that were helpful to the assessment and the team process. Present portion of entrance meeting/exit conference presentation Assure completion of sign in sheets for all meetings Compile and finalize (with grantor review) team s final debrief presentations Ensures full team review of powerpoint presentation for the final debriefing before final delivery. Strong Proficient

Strong Proficient Complete report assignment/timeline document with grantor input and return to program manager Question 10. Additional Comments: Limit response to 300 characters. 300 characters remaining Questions or Comments? Contact [name] at [e-mail address]