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)
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


Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps employees to maintain high personal standards.
  1. Conducts regular performance appraisals and feedback.
  1. Addresses employee behavior problems effectively.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Provides clear, motivating, and constructive feedback.
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. Communicates with department leadership
  1. Communicates effectively with colleagues and customers
  1. Communicates effectively with all levels of the organization.
  1. Deals with difficult situations calmly and confidently.
  1. Delivers influential presentations.
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. Steps away from a situation to process appropriate response.
  1. Analyzes interpersonal problems instead of reacting to them.
  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.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
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. Responds to requests for information in a timely manner.
  1. Maintains an efficient schedule of activities.
  1. Starts meetings on time.
  1. Invoices clients on a timely basis.
  1. Avoids making personal phone calls during working hours.
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. Shown significant improvement in job performance.
  1. Works effectively in the department.
  1. Effectively organizes resources and plans
  1. Has great overall performance
  1. ...Overall Performance
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. Goal Setting
  1. Makes sure that I have a clear idea of our group's goals.
  1. Understands & contributes to development of strategic goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Achieves established goals.
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. Keeps themselves and others focused on constant improvement.
  1. Produces high quality work.
  1. Takes a lot of pride in their work.
  1. Is planful and organized.
  1. Demonstrates the functional or technical skills necessary to do their job.
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. Sets a good example.
  1. Acts as a resource without removing individual responsibility.
  1. Responsible for setting the vision of the department.
  1. Completes assigned work tasks.
  1. Sets a good example
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. Able to adapt the department to changing business demands and climate.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Is comfortable operating in an environment of uncertainty.
  1. Balances risks and rewards when making decisions.
  1. Devotes a certain amount of time and effort to developing new business opportunities.
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. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands the use of [Company] products and services.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Attends [Company] gatherings and social events.
  1. Follows existing procedures and processes.
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.