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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)
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:
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
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Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses metrics such as the number of tasks completed, project milestones achieved, or output produced per hour to measure progress.
  1. Avoids actions that do not contribute to the achievement of the goal.
  1. Systematically follows a structured plan so that progress is consistently monitored and adjustments are made as necessary.
  1. Maintains unwavering focus on tasks and deliberately minimizes interruptions to ensure the successful accomplishment of goals.
  1. Has developed strong organizational and time management skills allowing for the completion of a variety of goals.
  1. Sets goals relevant to the situation to help teams focus their efforts efficiently.
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. Demonstrates a well-organized and timely approach to achieve desired results
  1. Develops and follows systematic plans that ensure timely delivery of results and organizational impact.
  1. Moves decisively to complete initiatives ahead of schedule.
  1. Systematically works to improve the organization
  1. Eliminates bureaucratic barriers to streamline processes.
  1. Moves decisively in high-risk situations to secure long-term achievements.
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. Keeps commitments made with coworkers.
  1. Strives to lead by example to demonstrate the value of interpersonal relationships.
  1. Anticipates the concerns of other employees.
  1. Values the input from coworkers.
  1. Builds strong relationships with team members.
  1. Sees values in the diversity of individuals on the team.
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. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Sets performance objectives for subordinates that encourages development opportunities.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Creates a work environment that fosters positive feedback to employees.
  1. Tries to ensure employees are ready to move to the next level.
  1. Is open to receiving feedback.
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. Able to adapt the department to changing business demands and climate.
  1. Has a strategic awareness on how to promote the organization.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Identifies issues that need to be addressed.
  1. Exhibits determination and passion in completion of goals.
  1. Has clarity of purpose in their actions.
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 strategy when new information is presented.
  1. Adjusts plans to meet new situations.
  1. Adjusts plans to meet the needs of new constraints.
  1. Adapts to new work processes and procedures.
  1. Adapts to diversity within the team.
  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. Moves forward on important projects.
  1. Successfully makes progress despite repeated failures or setbacks at work.
  1. Is proactive rather than reactive in work.
  1. Completes tasks despite obstacles encountered.
  1. Gladly accepts new challenges and works on them with urgency.
  1. Gets people to take action.
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. Pursues learning that will enhance job performance.
  1. Builds on their strengths while addressing their weaknesses.
  1. Views setbacks as opportunities to learn from.
  1. Is introspective and aware of own learning needs.
  1. Pursues self-improvement through continual learning.
  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. Demonstrates leadership and courage in critical situations.
  1. Uses feedback to modify duties, tasks, requirements, and goals when appropriate.
  1. Establishes methods and procedures for the department.
  1. Encourages others to question certain procedures which they may not understand and to communicate what they need.
  1. Adapts communication style to different stakeholders to gain buy-in effectively.
  1. Maintains focus on the current plan even if it means saying "no" to unnecessary, or unrelated, projects.
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. Is aware of the impact of decisions and informs others about potential outcomes.
  1. Openly admits when a choice didn't work out and uses it as a learning opportunity without becoming defensive.
  1. Asks for additional information when making critical decisions.
  1. Is creative about the decisions they make.
  1. Understands what factors are important for deciding if a decision is "worth it"?
  1. Tests proposed solutions to confirm they meet essential parameters before implementation.
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.