Achievement - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Achievement:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be combined with the responses received from others and a report will be generated for you to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Competencies Included:
Achievement, Interpersonal Skills, Coaching, Entrepreneurship, Action, Continual Learning, Adaptability, Leadership, Decision Making
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team


Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You allocate resources as needed to accomplish organizational goals.
  1. You take calculated risks.
  1. You help others to improve or meet standards of performance.
  1. You take reasonable risks to achieve desired results.
  1. Your work improves the quality of work on the production line.
  1. I set performance metrics to measure achievement or attainment of goals.
If you were to make improvements in Achievement, what are your suggestions for how you can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You secure cooperation from and/or persuades others to support your solutions and decisions
  1. I show appreciation for other's work.
  1. You recognize the contributions of others.
  1. You use tact, compassion, and sensitivity in interactions with others.
  1. You adapt management style to meet the needs of the individual or situation.
  1. You assist those in the department who need help in meeting performance metrics.
If you were to make improvements in Interpersonal Skills, what are your suggestions for how you can improve this?

Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You provide clear, motivating, and constructive feedback.
  1. You address employee behavior problems effectively.
  1. You conduct regular performance appraisals and feedback.
  1. You develop the skills and capabilities of others.
  1. You help employees to understand responsibilities, authority, and expectations.
  1. You coach employees in how to strengthen knowledge and skills to improve work performance.
If you were to make improvements in Coaching, what are your suggestions for how you can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You risk your time, effort, and reputation toward the completion of goals.
  1. You seek and utilize mentors to help guide your professional development.
  1. You work hard toward the realization of goals.
  1. You can work effectively in an environment of uncertainty.
  1. You identify problems that need solved.
  1. You exhibit determination and passion in completion of goals.
If you were to make improvements in Entrepreneurship, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I am decisive when making decisions.
  1. I take action when opportunities arise.
  1. You make effective decisions, even when under pressure.
  1. You assign tasks to individuals who are most able to perform them.
  1. You decide to act rather than remain passive.
  1. You fixe problems when they occur.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are open to new ideas and concepts.
  1. You improve on your skill sets.
  1. You pursue professional development opportunities when they arise.
  1. You expand your educational and future learning opportunities.
  1. You take the initiative to learn new skills.
  1. You are curious about learning new things.
If you were to make improvements in Continual Learning, what are your suggestions for how you can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I embrace change and foster an open-minded environment.
  1. You are able to adjusts tactics when things are not working as expected.
  1. You are proactive and takes steps to prepare for changes in the workplace.
  1. You are able to adjust to the new vision and mission of the company.
  1. You perform a wide range of tasks, respond to changes in direction and priorities and accept new challenges, responsibilities, and assignments.
  1. You adjust plans to meet the needs of new constraints.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You act decisively in implementing decisions.
  1. You appear to trust own instincts and insights.
  1. You motivate and challenges employees to attain a shared vision.
  1. You provide challenging assignments to employees.
  1. You focus team efforts on meeting the needs of the customers.
  1. You clearly explain performance expectations and goals to be reached at the beginning of a project, then let others decide how to achieve the goal.
If you were to make improvements in Leadership, what are your suggestions for how you can improve this?

Decision Making

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You exercise good judgment by making sound and informed decisions.
  1. You coach team members individually when "poor" decisions are made and helps them see what could have been done differently
  1. I evaluate information before making a final decision.
  1. I gather information before making a decision.
  1. I formulate imaginative decisions.
  1. You understand how different perspectives can help make better informed decisions.
If you were to make improvements in Decision Making, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.