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. Seeks projects in areas outside immediate responsibilities.
  1. Achieves goals.
  1. Establishes and documents goals and objectives.
  1. Sets short and long term goals for self without being pushed.
  1. Understands & contributes to development of strategic goals.
  1. Measures and evaluates performance as related to business/customer needs.
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 assignments on time.
  1. Completes work to given time frame and to budget
  1. Helps others to improve or meet standards of performance.
  1. Highly motivated to achieve or exceed performance standards.
  1. Takes calculated risks to achieve difficult goals.
  1. Completed required training and certification.
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. Comes across as credible, knowledgeable and sincere
  1. Is open to innovative ideas and suggestions from others
  1. Builds strong relationships with team members.
  1. Honest about owning up to mistakes made.
  1. Demonstrates an understanding of other points of view.
  1. Promotes acceptance of diverse viewpoints from team members.
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. Tries to ensure employees are ready to move to the next level.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Supports the successes of other employees.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Provides constructive feedback to others.
  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. Seeks and utilizes mentors to help guide professional development.
  1. Encourages dynamic growth opportunities.
  1. Risks his/her time, effort, and reputation toward the completion of goals.
  1. Finds unique ways to go around barriers to success.
  1. Is motivated to work toward the realization of goals.
  1. Balances risks and rewards when making decisions.
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. Effective in working with different personnel of the team.
  1. Is aware of changes in the environment.
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Able to quickly learn new ways of performing their job.
  1. Continually trying to improve skills to remain current.
  1. Is open to changes in policies and procedures.
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 decisive when making decisions.
  1. Looks for extra ways to help the department achieve performance goals.
  1. Acts quickly to create innovative products and services.
  1. Is proactive in addressing the needs of the department.
  1. Changes course to meet the needs of a new situation.
  1. Regularly conducts preventative maintenance on the equipment.
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. Takes charge of their training and skills enhancement.
  1. Takes the initiative to learn new skills.
  1. Initiates own actions for additional training and education.
  1. Views setbacks as opportunities to learn from.
  1. Improves on their skill sets.
  1. Seeks opportunities to grow in skills and 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. Provides challenging assignments to employees.
  1. Motivates and challenges employees to attain a shared vision.
  1. Holds team members accountable to commitments made
  1. Appears to trust own instincts and insights.
  1. Is a highly effective supervisor.
  1. Empowers others to succeed within their jobs.
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. Decides which long-term goals should be met.
  1. Is confident in the decisions they make.
  1. Understands how their decisions will affect others.
  1. Makes decisions based on novel interpretations of the facts.
  1. Examines for patterns in data to help predict future possibilities.
  1. Maintains focus on the "big picture" 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.