Achievement - 360 Degree Feedback Survey Sample #2





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

You have been selected to provide feedback on the employee listed above. 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 working with this employee over the last twelve months and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Competencies Included:
Achievement, Performance, Clarity, Client Focus, Persuasion and Influence, Co-worker Development, Creativity, Self Management, Leadership, Company, Fiscal Management
Sample Result Document:
Sample Results
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.

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


Achievement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Helps others to improve or meet standards of performance.
  1. Allocates resources as needed to accomplish organizational goals.
  1. Holds others to high standards of achievement.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Strives to meet goals and objectives.
What are your suggestions for how [Participant Name] can make improvements
in Achievement?

Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets a high standard for job performance.
  1. Shown significant improvement in job performance.
  1. Able to organize work.
  1. Listens and responds to issues and problems
  1. Effective in performing his/her job.
What are your suggestions for how [Participant Name] can make improvements
in Performance?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Attends to the important details of a job or task.
  1. Is clear about the roles and duties of team members.
  1. Adjusts communication methods to the needs of the audience.
  1. Avoids creating ambiguity or mixed messages.
  1. Maintains clarity in goals and objectives.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Acts with integrity in all client interactions.
  1. Is aware of the client's needs.
  1. Is aware of expectations from clients.
  1. Creates new and innovative products for clients.
  1. Consistently demonstrates a client focus.
What are your suggestions for how [Participant Name] can make improvements
in Client Focus?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Seeks to obtain consensus or compromise.
  1. Understanding what others need.
  1. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.
  1. Able to express own goals and needs.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Provides ongoing feedback to co-workers on their development progress
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Conceives, implements and evaluates ideas.
  1. Adds value to the department/organization.
  1. Creates a lot of new ideas.
  1. Develops solutions to challenging problems.
  1. Inspires creativity in their team.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Steps away from a situation to process appropriate response.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Uses patience and self-control in working with customers and associates.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes interpersonal problems instead of reacting to them.
What are your suggestions for how [Participant Name] can make improvements
in Self Management?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Expresses clear goals and objectives.
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Able to align manpower, design work, an allocate tasks to achieve goals.
  1. Takes ownership and accountability for results
  1. Sets specific, measurable, and challenging goals.
What are your suggestions for how [Participant Name] can make improvements
in Leadership?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Attends [Company] gatherings and social events.
  1. Understands the use of [Company] products and services.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Follows existing procedures and processes.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
What are your suggestions for how [Participant Name] can make improvements
in Company?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Keeps excellent records for financial transparency.
  1. Provides budgeting and accounting support to the Company.
  1. Monitors expenses and verifies the need for items purchased.
  1. Develops budgets and plans for various programs and initiatives.
  1. Develops of the department's annual budget.
What are your suggestions for how [Participant Name] can make improvements
in Fiscal Management?


  1. Strengths


  2. Areas for Development


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