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.

Competencies Included:
Commitment To Result, Excellence, Bias for Action, Establishing Focus/Direction, Client Focus, Communication Skills, Adaptability, Administrative Skill, Coaching, Teamwork, Others, Organizational Fluency, Fiscal Management
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. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Maintains persistence and dedication to achieving results.
  1. Committed to the team.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
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. Produces high quality work.
  1. Takes a lot of pride in their work.
  1. Is planful and organized.
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. Conveys a sense of urgency about addressing problems and opportunities
  1. Encourages risk taking and experimentation to improve performance
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Motivates others to achieve or exceed goals
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. Functions well under stress, deadlines, and/or significant workloads.
  1. Maintains self-control when personally criticized.
  1. Stays focused even when under pressure and stress.
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. Responsive to client needs.
  1. Actively listens to concerns from clients.
  1. Competent in managing client projects.
  1. Is available to respond to client needs.
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. Responds in a timely manner, respecting deadlines and others' schedules.
  1. Listens actively & speaks clearly and directly.
  1. Confidently interacts with all tiers of the organization.
  1. Uses software, graphics, or other aids to clarify complex or technical reports.
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. Works effectively with various personalities of team members.
  1. Adjusts plans as needed based on changing conditions.
  1. Adapts to new environments.
  1. Adapts to changes in team membership.
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. Takes responsibility for decisions.
  1. Enthusiastic about taking on challenging projects.
  1. Strong organizational skills to keep the workspace and department in order
  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. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Develops the skills and capabilities of others.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Helps employees to understand responsibilities, authority, and expectations.
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. Willingly share their technical expertise
  1. Facilitates good rapport between team members.
  1. Emphasizes the importance of getting individuals to work as a team
  1. Takes the time to listen to the team's ideas.
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. Able to see issues from others' perspectives.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Works across boundaries within the organization.
  1. Supports the efforts of other employees in implementing solutions to problems.
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. Understands departmental policies and procedures.
  1. Understands the current organizational culture.
  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. Effective in using Company's resources.
  1. Provides budgeting and accounting support to the Company.
  1. Keeps excellent records for financial transparency.
  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.