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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. Demonstrates the functional or technical skills necessary to do their job.
  1. Produces high quality work.
  1. Keeps themselves and others focused on constant improvement.
  1. Demonstrates the analytical skills 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. Leverages skills and resources to exceed performance expectations.
  1. Conducts critical-incident review immediately after the event.
  1. Approves purchase requests in a timely manner.
  1. Takes the initiative to address problems sooner rather than later.
  1. Takes proactive steps to address potential issues before they became a problem.
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. Starts meetings on time.
  1. Invoices clients on a timely basis.
  1. Arrives to meetings on time.
  1. Conducts appointments at scheduled start time.
  1. Responds to requests for information in a timely manner.
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. Immediately informs the HR Department of any personnel complaints or issues.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Gladly seeks additional responsibilities.
  1. Builds strong interpersonal relationships upon first meeting.
  1. Volunteers time and effort toward the completion of important goals.
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. Driven to complete goals despite obstacles that may arise.
  1. Increased revenue for the company.
  1. Rapidly completes tasks and assignments.
  1. Takes immediate action of projects that fall behind schedule.
  1. Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
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. Uses risk management to make better strategic decisions.
  1. Determines the amount of deviation from the plan that will be tolerated.
  1. Develops policies for risk management.
  1. Prioritizes the risks to determine the most pressing needs.
  1. Monitors the effectiveness of risk management strategies.
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. Is focused on improving customer services.
  1. Attends to the customer's needs in addition to the specific needs of the project.
  1. Delivers high quality products to the customer.
  1. Responsive to customer needs.
  1. Anticipates and proactively resolves issues that the customer may face.
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. Works to identify root causes of performance problems
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
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. Fosters a robust, collaborative setting; sets clear expectations; and introduces an agenda that matches priorities.
  1. Manages emotions to reduce the impact of negativity.
  1. Justifies viewpoints using strong and credible data.
  1. Able to collaborate with others in solving problems to create solutions that satisfy both parties' interests.
  1. Understands the current situation of both parties.
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. Effective in communicating with others within the organization.
  1. Able to explain departmental policies and procedures to others.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Adept at navigating within the culture of the department.
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.