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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)
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:
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
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Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Can be counted on to add value wherever they are involved.
  1. Takes a lot of pride in their work.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Is planful and organized.
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. Demonstrates resilience in the face of adversity.
  1. Gladly accepts new challenges and works on them with urgency.
  1. Decides to act rather than remain passive.
  1. Displays high energy and enthusiasm on consistent basis.
  1. Delegates tasks and assignments to subordinates as soon as a request has been made.
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. Arrives to meetings on time.
  1. Starts meetings on time.
  1. Responds to requests for information in a timely manner.
  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. Will continue to work on a problem even in the face of obstacles.
  1. Takes the initiative to change the direction or course of events.
  1. Addresses small problems before they become big ones.
  1. Capitalizes on opportunities as they become available.
  1. Sees what needs to be done and takes appropriate actions.
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. Completes work promptly and efficiently.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Successfully launched the ABC project.
  1. Cuts through red tape to enhance efficiency and remove unnecessary hurdles.
  1. Takes calculated risks to achieve higher levels of performance.
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. Adds value to the organization through acceptance of certain risk.
  1. Determines a proportional response in relation to the level of risk.
  1. Responds appropriately to unexplained or unanticipated events.
  1. Improves process safety where possible.
  1. Understands how to meet regulatory compliance.
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. Encourages others to adopt a customer-first mindset through actions.
  1. Responsive to customer needs.
  1. Creates high quality products for the customers.
  1. Creates innovative solutions to meet customer needs.
  1. Considers customers point of view when making decisions.
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. Provides ongoing feedback to co-workers on their development progress
  1. Takes immediate action on poor performance
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
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. Always has a "game plan" prior to entering into negotiations.
  1. Able to clearly express thoughts and concerns.
  1. Is aware of what problems need to be solved.
  1. Ensures a thorough understanding of key issues and priorities.
  1. Identifies goals and objectives desired as well as the strengths and weaknesses currently possessed.
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. Anticipates problems that may affect the department.
  1. Effective in communicating with others within the organization.
  1. Understands the current organizational culture.
  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.