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. Goal Setting
  1. Sets high expectations and goals; encourages others to support the organization.
  1. Keeps abreast of current developments pertaining to the job
  1. Seeks projects in areas outside immediate responsibilities.
  1. Sets short and long term goals for self without being pushed.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
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. Completed training on the new equipment.
  1. Motivated to exceed performance goals.
  1. Strives to meet goals and objectives.
  1. Successfully launched the ABC project.
  1. Sets challenging goals for the department.
  1. Sets ambitious standards of performance.
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. Shows appreciation for other's work.
  1. Gives good advice and suggestions to coworkers.
  1. Is open to innovative ideas and suggestions from others
  1. Defuses hostile/angry individuals in group settings to prevent disruption of work.
  1. Keeps and maintains confidentiality and trust.
  1. Demonstrates compassion and understanding of others.
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. Sets performance objectives for subordinates that encourages development opportunities.
  1. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Assesses employees' developmental needs.
  1. Is open to receiving feedback.
  1. Tries to ensure employees are ready to move to the next level.
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. Believes in their vision for the department/organization.
  1. Encourages dynamic growth opportunities.
  1. Balances risks and rewards when making decisions.
  1. Encourages risk taking for developing potential business opportunities.
  1. Works hard toward the realization of goals.
  1. Is motivated to work toward the realization of goals.
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. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Is aware of changes in the environment.
  1. Adapts to changes in team membership.
  1. Adjusts plans or schedules to deal with changing situations.
  1. Works effectively with various personalities of team members.
  1. Adjusts priorities to changing business goals.
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. Looks for extra ways to help the department achieve performance goals.
  1. Approves purchase requests in a timely manner.
  1. Pursues goals with action to achieve success.
  1. Moves forward on important projects.
  1. Initiates actions to get things done.
  1. Takes responsibility for actions.
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. Is introspective and aware of own learning needs.
  1. Pursues professional development opportunities when they arise.
  1. Expands their educational and future learning opportunities.
  1. Views setbacks as opportunities to learn from.
  1. Continues to ask questions about process and systems to further improve own knowledge.
  1. Grasps new ideas, concepts, technical, or business knowledge.
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. Able to influence others.
  1. Appears to trust own instincts and insights.
  1. Demonstrates leadership and courage in critical situations.
  1. Effectively leads others.
  1. Seeks input and ideas from employees by involving them in decisions.
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. Views the issues from multiple perspectives before making a decision.
  1. Regularly evaluates information before making important decisions.
  1. Examines relevant factors needed to make a decision.
  1. Receptive to new ideas from others when making decisions.
  1. Determines the costs and potential benefits of decisions.
  1. Remains focused on the immediate goal when making decisions.
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.