Goals - 360 Degree Feedback Survey Sample #8

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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Establishes and documents goals and objectives.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Goal Setting
  1. Achieves goals.
  1. Understands & contributes to development of strategic goals.

Juggling Multiple Responsibilities

Agree Unsure Disagree N/A
  1. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Can multi-task while performing all of their other responsibilities and activities.

Managing Risk

Agree Unsure Disagree N/A
  1. Recognizes that small changes may snowball into major events.
  1. Bases decisions on patterns found in fluid/changing information.
  1. Able to adapt quickly to changing situations.
  1. Seeks to maintain the long-term viability of the Company.
  1. Works within constraints of the organization.


Agree Unsure Disagree N/A
  1. Keeps informed of various regulations and procedures.
  1. Performs audits regularly, or without notice, to ensure proper compliance with regulations.
  1. Explains regulations and procedures to others as required.
  1. Ensures regulations are followed as required.
  1. Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.

Client Focus

Agree Unsure Disagree N/A
  1. Forms strong client relationships
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Obtains feedback to ensure client needs are being met.
  1. Satisfies client needs.
  1. Ensures client commitments and requirements are met or exceeded

Self Management

Agree Unsure Disagree N/A
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.


Agree Unsure Disagree N/A
  1. Contributes to a positive and fun work environment.
  1. Builds open and trusting relationships.
  1. Visibly supports and encourages diversity in style and background.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Works to eliminate unnecessary work or barriers that get in others' way.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Promotes teamwork and cooperation within the department.
  1. Delegates effectively.
  1. Provides constructive, ongoing feedback.
  1. Treats all staff equitably.
  1. Maintains good working relationships with employees.


Agree Unsure Disagree N/A
  1. Listens and responds to issues and problems
  1. Effective in performing his/her job.
  1. Works well in this position.
  1. Sets a high standard for job performance.
  1. ...Produce Quality

Problem Solving

Agree Unsure Disagree N/A
  1. Solves problems using logic and insight.
  1. Identifies and assesses all potential responses to a problem.
  1. Works cooperatively with others to solve problems.
  1. Able to balance the needs of different people in a solution to a problem.
  1. Is a good problem solver and decision maker


Agree Unsure Disagree N/A
  1. Conducts regular performance appraisals and feedback.
  1. Develops the skills and capabilities of others.
  1. Addresses employee behavior problems effectively.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Meets regularly with employees to coach them on areas that will enhance their performance

Business Acumen

Agree Unsure Disagree N/A
  1. Asks the 'right' questions to size up or evaluate situations.
  1. Considers impact of actions on other areas of the organization.
  1. Applies the knowledge of work processes to influence the achievement of business goals
  1. Understands complex issues and problems.
  1. Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance

Strategic Insight

Agree Unsure Disagree N/A
  1. Communicates vision for the department and company.
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.
  1. Identifies potential problems before they become critical incidents.
  1. Implements long-term solutions to problems.
  1. Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Understands the current organizational culture.
  1. Anticipates problems that may affect the department.
  1. Effective in communicating with others within the organization.
  1. Gets things done through the department.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.