Excellence - 360 Degree Feedback Survey Sample #2





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)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. 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 as an employee over the last twelve months and the goals you were asked to achieve. 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Excellence, Bias for Action, Leadership, Supervisory Skills, Persuasion and Influence, Decision Making, Innovation, Adaptability, Juggling Multiple Responsibilities, Technology Use/Management, Regulatory/Compliance, Client Focus, Teamwork, Strategic Focus
Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Excellence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You produce high quality work.
  1. You keep yourself and others focused on constant improvement.
  1. You demonstrate the analytical skills to do your job.
  1. You take a lot of pride in your work.
What are your suggestions for how you can make improvements
in Excellence?

Bias for Action

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. You encourage risk taking and experimentation to improve performance
  1. You seek and utilize opportunities for continuous learning and self-development.
  1. You motivate others to achieve or exceed goals
What are your suggestions for how you can make improvements
in Bias for Action?

Leadership

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You motivate others to reach and exceed organizational goals and objectives.
  1. You guide decision-making by coaching, counseling and rewarding.
  1. You seek input and ideas from employees by involving them in decisions.
  1. You find creative ways to reward employees for hard work.
What are your suggestions for how you can make improvements
in Leadership?

Supervisory Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You maintain good working relationships with employees.
  1. I oversee employees to make sure their work is performed up to standard.
  1. You provide constructive, ongoing feedback.
  1. I maintain professional interactions with peers, customers, and employees.
What are your suggestions for how you can make improvements
in Supervisory Skills?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are able to express own goals and needs.
  1. You attempt to persuade others rather than simply control them.
  1. You have excellent influencing/negotiating skills.
  1. You seek to obtain consensus or compromise.
What are your suggestions for how you can make improvements
in Persuasion and Influence?

Decision Making

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I make decisions that support the department's goals and objectives.
  1. You are confident in your actions.
  1. You take into account the impact decisions will have on others.
  1. I consider the ethical implications of decisions.
What are your suggestions for how you can make improvements
in Decision Making?

Innovation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You suggest new ideas at meetings.
  1. You foster a creative and innovative work environment.
  1. You create improved methods or solutions for meeting goals and objectives.
  1. You develop new products and services.
What are your suggestions for how you can make improvements
in Innovation?

Adaptability

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You easily accept new responsibilities.
  1. You are open to changes in policies and procedures.
  1. You are aware of changes to the policies and procedures.
  1. You are able to adapt to new environments.
What are your suggestions for how you can make improvements
in Adaptability?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You recognize and respond to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. You are aware of the deadlines for specific tasks/assignments.
  1. You can easily switch between tasks when a critical incident requires attention.
  1. You bounce back from daily crisis, disappointments and frustrations.
What are your suggestions for how you can make improvements
in Juggling Multiple Responsibilities?

Technology Use/Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You support employee training and development initiatives regarding implementation of technology.
  1. You are proficient in the use of technical systems and processes.
  1. You maximize the use of new technology to deliver products and services.
  1. You support technical training and development of employees.
What are your suggestions for how you can make improvements
in Technology Use/Management?

Regulatory/Compliance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I develop the appropriate incentives (or disincentives) for regulatory compliance.
  1. You offer training to employees to ensure they comply with regulations.
  1. You act as a liaison to regulatory agencies.
  1. I develop compliance reports to share with stakeholders.
What are your suggestions for how you can make improvements
in Regulatory/Compliance?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You ensure clients' expectations are met or exceeded.
  1. You view client satisfaction as an everyday priority.
  1. You demonstrate a commitment to client focus.
  1. You anticipate problems that the client may encounter.
What are your suggestions for how you can make improvements
in Client Focus?

Teamwork

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You act as an effective team player
  1. You demonstrate compassion and respect for others through actions; is concerned about their work and non-work issues
  1. You provide assistance and support to other team members when needed
  1. You communicate well with team members.
What are your suggestions for how you can make improvements
in Teamwork?

Strategic Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You make quick and creative decisions to adjust the strategy to meet the demands of changing situations.
  1. I identify and address strategic risks impacting operations.
  1. I exploit resources and capabilities to strategically increase production and responsiveness.
  1. You make decisions that yield more competitive advantages.
What are your suggestions for how you can make improvements
in Strategic Focus?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.