Adaptability - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Adaptability:
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:
Adaptability, Action, Self Management, Continual Learning, Leadership, Managing Performance, Juggling Multiple Responsibilities, Trustworthy, Developing Others, Teamwork
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


Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You adjust plans or schedules to deal with changing situations.
  1. You are able to respond to incidents without stopping the workflow.
  1. You are able to quickly learn new ways of performing your job.
  1. You are open to new ideas and innovations.
  1. You continually try to improve skills to remain current.
  1. You adjust strategy when new information is presented.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I take advantage of changes to the current situation.
  1. You take advantage of opportunities to move the organization forward.
  1. I make decisions confidently and stand by them.
  1. You decide to act rather than remain passive.
  1. I am proactive in addressing the needs of the department.
  1. I avoid "Analysis Paralysis" through action.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You consciously control own negative emotions in order to keep team morale up.
  1. You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You analyze interpersonal problems instead of reacting to them.
If you were to make improvements in Self Management, what are your suggestions for how you can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You take charge of your training and skills enhancement.
  1. You set relevant learning objectives and goals.
  1. You grasp new ideas, concepts, technical, or business knowledge.
  1. You expand your educational and future learning opportunities.
  1. You seek opportunities to grow in skills and knowledge.
  1. You are open to new ideas and concepts.
If you were to make improvements in Continual Learning, what are your suggestions for how you can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are able to align manpower, design work, an allocate tasks to achieve goals.
  1. You focus others on the necessary tasks that need completion.
  1. You are a highly effective supervisor.
  1. You encourage dialogue to clarify decision making and inform staff
  1. You act decisively in implementing decisions.
  1. You influence the decisions made at the Company.
If you were to make improvements in Leadership, what are your suggestions for how you can improve this?

Managing Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I train and develop employees to realize their maximum potential.
  1. You use timely and appropriate corrective/disciplinary actions.
  1. I am consistent in clearly communicating job requirements.
  1. You routinely hold audits of performance on a weekly or monthly basis.
  1. I ensure team members receive rewards for positive performance accomplishments.
  1. I make sure the team's goals are met.
If you were to make improvements in Managing Performance, what are your suggestions for how you can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You complete multiple tasks simultaneously.
  1. You delegate tasks to others when needed.
  1. You bounce back from daily crisis, disappointments and frustrations.
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You keep track of multiple assignments and deadlines.
  1. You switch attention to more urgent tasks when necessary.
If you were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how you can improve this?

Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are a person others can count on.
  1. You demonstrate a sense of responsibility and commitment to public trust.
  1. You build and maintain the trust of others.
  1. You deliver on promises made.
  1. You communicate an understanding of the other person's interests, needs and concerns.
  1. You are trustworthy; is someone that can be trusted.
If you were to make improvements in Trustworthy, what are your suggestions for how you can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You assign tasks and responsibilities to develop skills of others.
  1. You recognize and celebrates accomplishments of others.
  1. You set performance objectives for subordinates that encourages development opportunities.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You encourage employees through recognition of positive changes in behavior.
  1. You try to ensure employees are ready to move to the next level.
If you were to make improvements in Developing Others, what are your suggestions for how you can improve this?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I work with other team members on the project.
  1. You come across as a reliable, committed team member
  1. You take the time to actively listen to other team member's perspectives.
  1. You join with other team members to brainstorm solutions to the problem.
  1. I find opportunities to recognize and reward team members.
  1. I make decisions that support the team's goals and objectives.
If you were to make improvements in Teamwork, 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.