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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. Taps into the skills of trusted contacts to elevate performance and problem-solving.
  1. Adapts quickly to new tools, systems, and technological trends.
  1. Seeks to get a better understanding of complex issues and problems.
  1. Works diligently on priority tasks until they are fully completed.
  1. Models objective self-evaluation as a foundation for continuous improvement.
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. Takes advantage of opportunities to move the organization forward.
  1. Creates performance measures to ensure action by the department.
  1. Looks for extra ways to help the department achieve performance goals.
  1. Acts quickly to create innovative products and services.
  1. Determines the best person for a specific task within the team.
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. Conducts appointments at scheduled start time.
  1. Invoices clients on a timely basis.
  1. Responds to requests for information in a timely manner.
  1. Avoids making personal phone calls during working hours.
  1. Starts the workday when scheduled.
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 action without being asked.
  1. Encourages others on the team to suggest process improvements.
  1. Creates solutions to problems as soon as an incident occurs.
  1. Takes on additional tasks without being asked or told to do so.
  1. Maintains steady progress on long-term tasks without reminders, consistently meeting milestones through self-management.
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. Reduced department expenses by 25 percent.
  1. Rapidly completes tasks and assignments.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Empowers individuals through strategic planning and resource allocation to optimize outcomes.
  1. Always sets high standards for their work and the work of their colleagues.
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. Evaluates the impact of certain events on the attainment of corporate objectives.
  1. Accurately perceives potential risks in the workplace.
  1. Offers training to reduce safety incidents in the workplace.
  1. Reviews historical risk events to anticipate future patterns.
  1. Takes steps to reduce the occurrence of the risk events.
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. Consistently models positive customer service attitudes.
  1. Able to handle difficult customers.
  1. Takes the initiative in solving difficult customer issues.
  1. Attends to the customer's needs in addition to the specific needs of the project.
  1. Prepares contingency plans for potential service disruptions that could impact customer satisfaction.
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. Gives others development opportunities through project assignments and increased job responsibilities
  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. 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. Able to manage and resolve conflicts constructively.
  1. Makes initial offers based on high aspirations conveying a robust BATNA (Best Alternative to a Negotiated Settlement).
  1. Is flexible in responses.
  1. Able to adapt to dynamic situations created by new information or unexpected challenges.
  1. Communicates the consequences of crossing established limits in a calm, professional manner to reinforce accountability and protect core interests.
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. Anticipates problems that may affect the department.
  1. Able to use corporate politics to advance department objectives.
  1. Effective in communicating with others within the organization.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Able to explain departmental policies and procedures to others.
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.