Goals - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Goals:
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:
Goals, Achievement, Interpersonal Skills, Developing Others, Entrepreneurship, Adaptability, Action, Continual Learning, Leadership, Decision Making,
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


Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Keeps abreast of current developments pertaining to the job
  1. Goal Setting
  1. Seeks projects in areas outside immediate responsibilities.
  1. Understands & contributes to development of strategic goals.
  1. Makes sure that team members have a clear idea of our group's goals.
If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets challenging goals for the department.
  1. Establishes Specific Measurable Achievable Realistic and Timed (SMART) goals.
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Rapidly completes tasks and assignments.
  1. Completes work to given time frame and to budget
  1. Holds others to high standards of achievement.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is well respected in the department.
  1. Demonstrates compassion and understanding of others.
  1. Attends to both the content and the context of what was being said.
  1. Coaches others how to communicate with influence and persuasion.
  1. Maintains a high degree of honesty and integrity.
  1. Gives constructive feedback on performance reviews.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Supports the successes of other employees.
  1. Is open to receiving feedback.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Assesses employees' developmental needs.
  1. Creates opportunities for professional development.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is motivated to work toward the realization of goals.
  1. Finds unique ways to go around barriers to success.
  1. Balances risks and rewards when making decisions.
  1. Identifies problems that need solved.
  1. Works hard toward the realization of goals.
  1. Encourages dynamic growth opportunities.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Adjusts tactics and strategies.
  1. Will stop what they are doing to help colleagues in need.
  1. Handles unexpected events without a loss of productivity.
  1. Adjusts to new plans and procedures.
  1. Able to step in and help co-workers when needed.
  1. Handles changes easily.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is not afraid to take action when necessary.
  1. Addresses performance issues quickly.
  1. Undertakes actions to achieve specific goals.
  1. Motivates & supports others to gain skills
  1. Pursues goals with action to achieve success.
  1. Looks for extra ways to help the department achieve performance goals.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Seeks opportunities to grow in skills and knowledge.
  1. Initiates own actions for additional training and education.
  1. Is open to new ideas and concepts.
  1. Is curious about learning new things.
  1. Pursues learning that will enhance job performance.
  1. Pursues professional development opportunities when they arise.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to align manpower, design work, an allocate tasks to achieve goals.
  1. Takes ownership and accountability for results
  1. Is accessible and approachable to associates.
  1. Encourages dialogue to clarify decision making and inform staff
  1. Demonstrates effective leadership talent and skills
  1. Gives inspiring presentations or discussions.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Decision Making

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Makes decisions independently (without having to be told what or how).
  1. Facilitates meetings with others to try to consider alternative courses of action.
  1. Willing to consider information from other sources.
  1. Understands how different perspectives can help make better informed decisions.
  1. Exercises good judgment by making sound and informed decisions.
  1. Is aware of the impact of decisions and informs others about potential outcomes.
If [Participant Name] were to make improvements in Decision Making, 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.