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Continuous Improvement - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Continuous 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:
Continuous 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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Continuous Improvement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I form cross-functional Operational Improvement Teams representing every department.
  1. You actively remove obstacles that limit employees' ability to drive improvements in their work.
  1. I establish priorities for continual improvement.
  1. I set industry-leading performance standards and benchmarks.
  1. I consistently prioritize and invest personal effort in continuous improvement.
If you were to make improvements in Continuous Improvement, what are your suggestions for how you can improve this?

Establishing Focus/Direction

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I break down larger tasks into smaller ones to help employees maintain focus.
  1. You set appropriate goals for employees.
  1. You identify gaps in infrastructure or support and proactively address them.
  1. I develop frameworks and systems to guide the organization toward achieve its goals.
  1. I create well articulated goals for the team to pursue.
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. I effectively communicate a point of view.
  1. I translate complex technical or strategic issues into accessible language that motivate action.
  1. I know how to win an argument.
  1. I objectively present multiple viewpoints before guiding others toward a well-supported conclusion.
  1. I listen actively and adapt messaging to resonate with different viewpoints without diluting the core message.
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 meticulously record and maintain logs of observations/measurements.
  1. You are comfortable working with numbers and data.
  1. You analyze issues and reduce them to their component parts.
  1. You recognize areas of missing data and suggests other ways to obtain the needed information.
  1. I optimize limited resources, such as time and money, by finding the most efficient solutions to problems.
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 recognize and implement changes to enhance efficiency and effectiveness.
  1. I am able to meet the needs of various stakeholders.
  1. I am able to work on various customer accounts which have different needs/goals.
  1. You pivot quickly in response to shifting project needs.
  1. You change to meet new priorities within the department/organization.
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 analytical skills to do your job.
  1. You take a lot of pride in your work.
  1. You can be counted on to add value wherever you are involved.
  1. You demonstrate the functional or technical skills necessary to do your job.
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 model excellent customer service for others in the department.
  1. You are pro-active in dealing with customers and addressing your needs.
  1. You prioritize customer issues to tackle the most pressing needs first.
  1. I keep the customer informed of all progress.
  1. I provide a responsive service that meets the needs of 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 recognize and celebrates accomplishments of others.
  1. You create opportunities for professional development.
  1. You assess employees' developmental needs.
  1. You try to ensure employees are ready to move to the next level.
  1. You support the successes of other employees.
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 seek to develop a shared understanding of the issues involved.
  1. I demonstrate how to de-escalate through tone, body language, and word choice.
  1. I distinguish between surface-level disagreements and deeper systemic issues, ensuring interventions target the right level.
  1. You persuade others to accept personal transformation.
  1. I identify the root sources of 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 budgets and plans for various programs and initiatives.
  1. You are effective in using company's resources.
  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.
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.