Commitment to Result - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Commitment to Results:
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.

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


Commitment To Result

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Maintains persistence and dedication to achieving results.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Coordinates all department activities into a cohesive team effort.
  1. Able to focus on a task even when working alone.
If [Participant Name] were to make improvements in Commitment To Result, 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. Demonstrates the functional or technical skills necessary to do their job.
  1. Can be counted on to add value wherever they are involved.
  1. Takes a lot of pride in their work.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Bias for Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Completes a large volume of work.
  1. Displays high energy and enthusiasm on consistent basis.
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Conveys a sense of urgency about addressing problems and opportunities
If [Participant Name] were to make improvements in Bias for Action, what are your suggestions for how he/she can improve this?

Establishing Focus/Direction

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Excellent at managing time.
  1. Stays focused even when under pressure and stress.
  1. Functions well under stress, deadlines, and/or significant workloads.
  1. Helps guide employees with prioritizing tasks.
If [Participant Name] were to make improvements in Establishing Focus/Direction, what are your suggestions for how he/she can improve this?

Client Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Prioritizes client issues to tackle the most pressing needs first.
  1. Makes client's needs a top priority.
  1. Anticipates and proactively resolves issues that the client may face.
  1. Gets feedback from the client on a weekly basis.
If [Participant Name] were to make improvements in Client Focus, what are your suggestions for how he/she can improve this?

Communication Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Checks for understanding throughout conversations or group presentations/discussions
  1. Communicates effectively with colleagues and customers
  1. Delivers influential presentations.
  1. Gives clear and convincing presentations.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to step in and help co-workers when needed.
  1. Is open to new ideas and innovations.
  1. Is flexible when dealing with changes.
  1. Embraces change and fosters an open-minded environment.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Administrative Skill

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Strong organizational skills to keep the workspace and department in order
  1. Implements and uses performance measures.
  1. Has strong technical/computer skills.
  1. Accurately implements contract provisions.
If [Participant Name] were to make improvements in Administrative Skill, what are your suggestions for how he/she can improve this?

Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Meets regularly with employees to coach them on areas that will enhance their 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?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps other team members to research solutions to a problem.
  1. Facilitates team discussions and problem-solving
  1. Expresses appreciation for the work of other team members.
  1. Actively participates as a team member
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Treats others with respect and dignity.
  1. Works effectively with people from other departments.
  1. Is able to see issues from others' perspectives.
  1. Works across boundaries within the organization.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Organizational Fluency

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to explain departmental policies and procedures to others.
  1. Effective in communicating with others within the organization.
  1. Anticipates problems that may affect the department.
  1. Able to use corporate politics to advance department objectives.
If [Participant Name] were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?

Fiscal Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Keeps excellent records for financial transparency.
  1. Provides budgeting and accounting support to the Company.
  1. Develops budgets and plans for various programs and initiatives.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
If [Participant Name] were to make improvements in Fiscal Management, 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.