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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. Keeps abreast of current developments pertaining to the job
  1. Goal Setting
  1. Establishes and documents goals and objectives.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Measures and evaluates performance as related to business/customer needs.
  1. Sets short and long term goals for self without being pushed.
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. Driven to complete goals despite obstacles that may arise.
  1. Takes calculated risks to achieve difficult goals.
  1. Systematically works to improve the organization
  1. Increased customer satisfaction scores for the quarter.
  1. Establishes stretch goals to advance skills and output.
  1. Eliminates bureaucratic barriers to streamline processes.
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. Successfully resolves conflicts and grievances to a win-win solution.
  1. Creates an atmosphere that supports the open expression of ideas
  1. Gives honest opinions when asked.
  1. Willing to communicate in person instead of through a mobile device.
  1. Is honest about making mistakes and willing to fix them.
  1. Is a committed and reliable partner.
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. Encourages employees through recognition of positive changes in behavior.
  1. Supports the successes of other employees.
  1. Creates opportunities for professional development.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Recognizes and celebrates accomplishments of others.
  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. Takes the initiative to complete tasks.
  1. Excellent at managing relationships with stakeholders.
  1. Knows when to listen to the advice of others.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Has clarity of purpose in their actions.
  1. Exhibits a high sense of self-belief.
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 to the new vision and mission of the company.
  1. Able to respond to incidents without stopping the workflow.
  1. Works effectively with various personalities of team members.
  1. Will stop what they are doing to help colleagues in need.
  1. Able to adapt to changes in technology and processes.
  1. Accommodates changes as needed.
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. Fixes problems when they occur.
  1. Establishes the tasks and direction for the team.
  1. Acts immediately instead of waiting for someone else to solve the issue.
  1. Does not procrastinate when there is a job to be done.
  1. Takes on additional responsibilities outside of the job description to help the team succeed.
  1. Is not afraid to take action when necessary.
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. Builds on their strengths while addressing their weaknesses.
  1. Is introspective and aware of own learning needs.
  1. Pursues learning that will enhance job performance.
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Continues to ask questions about process and systems to further improve own knowledge.
  1. Sets relevant learning objectives and goals.
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. Holds team members accountable to commitments made
  1. Sets specific, measurable, and challenging goals.
  1. Consistently follows the Commitments to Communication in dealing with others
  1. Guides decision-making by coaching, counseling and rewarding.
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Expresses clear goals and objectives.
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. Defines parameters that will impact the decision making process.
  1. Exercises good judgment by making sound and informed decisions.
  1. Has enough self-control to avoid making impulsive decisions.
  1. Receptive to new ideas from others when making decisions.
  1. Is able to make decisions quickly.
  1. Applies creative reasoning in 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.