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. Sets challenging goals.
  1. Reduces staff turnover.
  1. Completes work promptly and efficiently.
  1. Successfully completed the orientation training program.
  1. Completes work to a high technical standard
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. Works well in this position.
  1. Shown significant improvement in job performance.
  1. Effectively organizes resources and plans
  1. Sets a high standard for job performance.
  1. Has great overall performance
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. Communicates ideas and facts clearly and effectively in writing.
  1. Attends to the important details of a job or task.
  1. Communicates with clarity and efficiency.
  1. Avoids stating unclear or conflicting goals.
  1. Clarifies problems and their causes to help employees correct them.
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. Demonstrates a commitment to client focus.
  1. Adapts to changes proposed by the client.
  1. Follows up with any unanswered questions from the client.
  1. Able to handle difficult clients.
  1. Delivers on commitments made to clients.
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. Develops a good rapport with others.
  1. Able to express own goals and needs.
  1. Attempts to persuade others rather than simply control them.
  1. Seeks to obtain consensus or compromise.
  1. Understanding what others need.
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. Sets and clearly communicates expectations, performance goals, and measurements to others
  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
  1. Takes immediate action on poor performance
  1. Works to identify root causes of performance problems
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. Is creative and inspirational.
  1. Inspires creativity in their team.
  1. Creates a lot of new ideas.
  1. Adds value to the department/organization.
  1. Develops solutions to challenging problems.
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. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Steps away from a situation to process appropriate response.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  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. Guides decision-making by coaching, counseling and rewarding.
  1. Sets specific, measurable, and challenging goals.
  1. Highly effective supervisor.
  1. Gives direct, constructive, and actionable feedback.
  1. Sets clear goals and objectives for subordinates.
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. Understands the "basics" as to how [Company] functions/operates.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Follows existing procedures and processes.
  1. Impresses upon others the important aspects of [Company].
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. Monitors spending.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Develops budgets and plans for various programs and initiatives.
  1. Keeps excellent records for financial transparency.
  1. Provides budgeting and accounting support to the Company.
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.