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)
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.

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


Continual Improvement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You promote training and development opportunities to enhance job performance.
  1. You analyze processes to determine areas for improvement.
  1. You look for ways to expand and learn new job skills.
  1. You look for ways to improve work processes and procedures.
  1. You are open to the suggestions from others.
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 maintain self-control when personally criticized.
  1. You help guide employees with prioritizing tasks.
  1. You are excellent at managing time.
  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.
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 are able to express own goals and needs.
  1. You understand what others need.
  1. You attempt to persuade others rather than simply control them.
  1. You develop a good rapport with others.
  1. You persuade others to consider alternative points of view.
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. You identifiy opportunities for progress and innovation.
  1. You balance risks and costs with the reward and probabilities of success when decisions.
  1. You prioritize various actions to be taken when solving a problem.
  1. You use appropriate techniques to solve problems.
  1. You analyze data and information from several sources and arrives at logical conclusions.
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 continually try to improve skills to remain current.
  1. You are able to step in and help co-workers when needed.
  1. You work effectively with various personalities of team members.
  1. You are flexible when dealing with changes.
  1. You are able to recognize the potential benefits of change, and create an infrastructure which supports change.
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 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 demonstrate the analytical skills to do your job.
  1. You are planful and organized.
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. I make sure customer needs are understood by the team members.
  1. You interact with customers to define roles, expectations, and responsibilities.
  1. I provide training to others on how to improve customer service.
  1. You use feedback from the customer to help improve the customer's experience.
  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 support the successes of other employees.
  1. You create opportunities for professional development.
  1. You try to ensure employees are ready to move to the next level.
  1. You develop employees by offering and encouraging them to take on new or additional responsibilities.
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. You identify and takes steps to prevent potential confrontations.
  1. You assist team members by helping them see the other point of view.
  1. You help employees to think through alternative ways to resolve conflict situations.
  1. You try to understand others' point of view before making judgments
  1. You clearly express expectations to others.
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 are effective in using company's resources.
  1. You keep excellent records for financial transparency.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You ensure others follow the correct rules and regulations on fiscal matters.
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.