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Coaching- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Coaching:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions:

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

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. 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 aggregated with the responses received from others and discussed with the employee 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:
Coaching, Communication Skills, Self Management, Punctuality, Performance, Goals, Excellence, Responsible, Entrepreneurship, Company
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
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Would you like to edit this survey? Click here to begin.


Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Offers guidance and perspective without being prescriptive.
  1. Offers coaching at the appropriate times.
  1. Uses coaching to help maximize employee output.
  1. Considers the ideas and suggestions from coaches.
  1. Guides the employee to focus on the future rather than dwelling on what went wrong.
If [Participant Name] were to make improvements in Coaching, what are your suggestions for how he/she can improve this?

Communication Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Delivers effective presentations.
  1. Able to communicate ideas effectively and succinctly to both individuals and groups, in any setting.
  1. Is approachable and accessible when needed.
  1. Confidently interacts with all tiers of the organization.
  1. Informs others about changes or developments in plans and goals.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses patience and self-control in working with customers and associates.
  1. Steps away from a situation to process appropriate response.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Punctuality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Arrives to meetings on time.
  1. Responds to requests for information in a timely manner.
  1. Maintains an efficient schedule of activities.
  1. Conducts appointments at scheduled start time.
  1. Starts the workday when scheduled.
If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Listens and responds to issues and problems
  1. Sets a high standard for job performance.
  1. Works effectively in the department.
  1. ...Produce Quality
  1. Effective in performing his/her job.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Develops multiple scenarios and strategies to prepare for various future possibilities and ensures that goals are adaptable to changing circumstances.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Demonstrates a track record of successfully accomplishing a wide range of goals, spanning various areas and disciplines.
  1. Successful in completing a diverse set of goals.
  1. Defines goals on a path of ongoing improvement.
If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Can be counted on to add value wherever they are involved.
  1. Keeps themselves and others focused on constant improvement.
  1. Is planful and organized.
  1. Demonstrates the analytical skills to do their job.
  1. Produces high quality work.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Responsible

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Acts as a resource without removing individual responsibility.
  1. Holds herself / himself accountable to goals / objectives
  1. Behavior is ethical and honest.
  1. Completes assigned work tasks.
  1. Sets high personal standards of performance.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Understands the processes and various stages of business development.
  1. Devotes a certain amount of time and effort to developing new business opportunities.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Finds unique ways to go around barriers to success.
  1. Excellent at managing relationships with stakeholders.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

Company

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Promotes a speak-up culture where ethical concerns are welcomed and addressed constructively.
  1. Has created an excellent training and development department.
  1. Provides employees the space and tools needed to stay focused.
  1. Strives to provide a good environment for clients and staff.
  1. Communicates with employees about the changes that are going to take place.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she 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.