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Empowering Others- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Empowering Others:
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:

[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:
Empowering Others, Excellence, Integrity, Professional Development, Administrative Skill, Innovation, Commitment To Result, Safety, Trustworthy, Planning
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
Edit this Survey
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Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Lets employees make their own decisions.
  1. Allows employees to make their own decisions.
  1. Sets clear goals for others to accomplish.
  1. Supports the decisions of others even if those decisions may sometimes lead to mistakes.
  1. Creates a culture where employees are given the opportunity to take the initiative and make impactful decisions.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is planful and organized.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Produces high quality work.
  1. Can be counted on to add value wherever they are involved.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Integrity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates sincerity in actions with others.
  1. Fosters an environment built upon trust.
  1. Follows tasks to completion.
  1. Fosters a high standard of ethics and integrity.
  1. Does what was promised.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?

Professional Development

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Allows employees to fully participate in employee training and professional development.
  1. Seeks opportunities for professional development.
  1. Seeks opportunities for continuous learning.
  1. Contributing fully to the extent of their skills
If [Participant Name] were to make improvements in Professional Development, what are your suggestions for how he/she can improve this?

Administrative Skill

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to develop, justify and present a budget.
  1. Enthusiastic about taking on challenging projects.
  1. Accurately implements contract provisions.
  1. Has strong technical/computer skills.
  1. High attention to detail.
If [Participant Name] were to make improvements in Administrative Skill, what are your suggestions for how he/she can improve this?

Innovation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Encourages innovation from all levels of employees.
  1. Encourages others to experiment and learn from their mistakes without fear of retribution.
  1. Creates innovative products or services.
  1. Customizes novel ideas to better address customer needs and preferences.
  1. Searches for opportunities and innovative ways to improve the organization.
If [Participant Name] were to make improvements in Innovation, what are your suggestions for how he/she can improve this?

Commitment To Result

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to focus on a task even when working alone.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Committed to the team.
  1. Maintains persistence and dedication to achieving results.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?

Safety

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Identifies predictable hazards in the workplace.
  1. Performs work safely.
  1. Creates accurate and effective measures of safety.
  1. Is aware of OSHA safety guidelines.
  1. Encourages others to attend safety training.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates congruence between statements and actions.
  1. Is trustworthy; is someone I can trust.
  1. Consistently keeps commitments.
  1. Takes care to maintain confidential information.
  1. Communicates an understanding of the other person's interests, needs and concerns.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

Planning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Assesses the risks of various strategic plans.
  1. Develops strategic plans for the company/organization.
  1. Determines what supplies/equipment will be needed for the job.
  1. Creates to-do lists to make sure nothing is missed.
  1. Determines the allocation of funds based on plans for future development.
If [Participant Name] were to make improvements in Planning, 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.