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Continual Improvement - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Continual Improvement:
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 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:
Continual Improvement, Establishing Focus/Direction, Persuasion and Influence, Analytical, Adaptability, Excellence, Customer Focus, Developing Others, Conflict Management, 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
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Continual Improvement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You search for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. You are open to the suggestions from others.
  1. You analyze processes to determine areas for improvement.
  1. You promote training and development opportunities to enhance job performance.
  1. You look for ways to expand current job responsibilities.
If you were to make improvements in Continual Improvement, what are your suggestions for how you can improve this?

Establishing Focus/Direction

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You stay focused even when under pressure and stress.
  1. You make sure that employees understand and identify with the team's mission.
  1. You align the department's goals with the goals of the organization.
  1. You make sure that employees understand how their work relates to organizational goals.
  1. You set appropriate goals for employees.
If you were to make improvements in Establishing Focus/Direction, what are your suggestions for how you can improve this?

Persuasion and Influence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You communicate effectively with others.
  1. You seek to obtain consensus or compromise.
  1. You develop a good rapport with others.
  1. You persuade others to consider alternative points of view.
  1. You are able to express own goals and needs.
If you were to make improvements in Persuasion and Influence, what are your suggestions for how you can improve this?

Analytical

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I understand how supplier relationships affect inventory levels, production schedules, and customer satisfaction.
  1. You are able to recall relevant information when needed.
  1. I am able to prepare appropriate visualizations of data in charts, graphs, and reports.
  1. You are ready and capable of exploring alternative viewpoints and strategies.
  1. You are well-versed in fundamental research concepts.
If you were to make improvements in Analytical, what are your suggestions for how you can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
  1. You adapt to diversity within the team.
  1. You are responsive to the needs of others.
  1. You are aware of changes in the environment.
  1. You are able to respond to incidents without stopping the workflow.
If you were to make improvements in Adaptability, what are your suggestions for how you can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You take a lot of pride in your work.
  1. You produce high quality work.
  1. You demonstrate the functional or technical skills necessary to do your job.
  1. You keep yourself and others focused on constant improvement.
  1. You can be counted on to add value wherever you are involved.
If you were to make improvements in Excellence, what are your suggestions for how you can improve this?

Customer Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You ask questions and listen carefully to determine customer needs and to ensure that the customer's needs are met.
  1. You view customer satisfaction as an everyday priority.
  1. I am committed to the success of the customer.
  1. I build long term relationships with customers.
  1. You promote, implement, maintain and enhances relationships with customers.
If you were to make improvements in Customer Focus, what are your suggestions for how you can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You create a work environment that fosters positive feedback to employees.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
  1. You recognize and celebrates accomplishments of others.
  1. You provide constructive feedback to others.
  1. You create opportunities for professional development.
If you were to make improvements in Developing Others, what are your suggestions for how you can improve this?

Conflict Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I encourage both sides to make compromises to resolve the conflict.
  1. You determine what issues can be agreed upon.
  1. I prefer to resolve conflicts through negotiation rather than coersion.
  1. I seek to achieve mutually acceptable outcomes.
  1. I work to meet the basic needs of each side in the conflict.
If you were to make improvements in Conflict Management, what are your suggestions for how you can improve this?

Fiscal Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You develop of the department's annual budget.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You ensure others follow the correct rules and regulations on fiscal matters.
  1. You monitor spending.
  1. You monitor expenses and verify the need for items purchased.
If you were to make improvements in Fiscal Management, 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.