Excellence - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Excellence:
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:
Excellence, Action, Punctuality, Initiative, Achievement, Managing Risk, Customer Focus, Co-worker Development, Negotiation, Organizational Fluency
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


Excellence

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

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Works across organizational lines and boundaries to attain goals.
  1. Approves purchase requests in a timely manner.
  1. Motivates & supports others to gain skills
  1. Drives and mobilizes others progress toward goals.
  1. Decides to act rather than remain passive.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Punctuality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Maintains an efficient schedule of activities.
  1. Starts the workday when scheduled.
  1. Starts meetings on time.
  1. Avoids making personal phone calls during working hours.
  1. Conducts appointments at scheduled start time.
If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Initiative

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Takes advantage of opportunities when they become available.
  1. Initiates new projects for the department.
  1. Capitalizes on opportunities as they become available.
  1. Looks for opportunities to move projects forward.
  1. Inspires others to perform above expectations.
If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Accepts setbacks and challenges as improvement opportunities
  1. Increased customer satisfaction scores for the quarter.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Strives to exceed standards of performance.
  1. Eliminates bureaucratic barriers to streamline processes.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Managing Risk

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Prioritizes risks to act on critical issues first.
  1. Determines a proportional response in relation to the level of risk.
  1. Has the knowledge and skills to accurately identify risks in the workplace.
  1. Determines the risk tolerance of the company.
  1. Establish roles, responsibilities, procedures.
If [Participant Name] were to make improvements in Managing Risk, what are your suggestions for how he/she can improve this?

Customer Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Engages with customers on multiple levels.
  1. Helps customers feel they are receiving services tailored specifically to their needs.
  1. Creates innovative solutions to meet customer needs.
  1. Is committed to the success of the customer.
  1. Is focused on improving customer services.
If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?

Co-worker Development

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Provides ongoing feedback to co-workers on their development progress
  1. Takes immediate action on poor performance
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?

Negotiation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Keeps a firm grasp on the issues and priorities.
  1. Able to influence others to accept certain positions.
  1. Leverages relationships with others to achieve goals.
  1. Able to adapt to dynamic situations created by new information or unexpected challenges.
  1. Able to control their emotional responses and correctly gauge the emotions of others.
If [Participant Name] were to make improvements in Negotiation, what are your suggestions for how he/she can improve this?

Organizational Fluency

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Gets things done through the department.
  1. Understands the current organizational culture.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Able to use corporate politics to advance department objectives.
  1. Understands departmental policies and procedures.
If [Participant Name] were to make improvements in Organizational Fluency, 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.