Initiative - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Initiative:
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:
Quality, Integrity, Continual Learning, Leadership, Persuasion and Influence, Technical, Interpersonal Skills, Developing Others, Others, Entrepreneurship, Global Perspective
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


Initiative

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Takes action to implement new changes in the policies and procedures.
  1. Initiates the development of new products.
  1. Takes advantage of opportunities when they become available.
  1. Quickly comes to the aid of those who may need help.
  1. Acts independently to solve pressing needs.
If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Prioritizes tasks for efficiency.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Adapts to changes in team membership.
  1. Recognizes and implements changes to enhance efficiency and effectiveness.
  1. Easily accepts new responsibilities.
  1. Adjusts priorities to changing business goals.
  1. Adjusts tactics and strategies.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Uses patience and self-control in working with customers and associates.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
If [Participant Name] were to make improvements in Self Management, 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. Motivates others to reach and exceed organizational goals and objectives.
  1. Is a highly effective supervisor.
  1. Gives inspiring presentations or discussions.
  1. Effectively leads others.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses established goals and performance measures to keep track of performance.
  1. Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
  1. Works at a quick pace to complete a high volume of work.
  1. Completes work to a high technical standard
  1. Successfully launched the ABC project.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Can be counted on to add value wherever they are involved.
  1. Takes a lot of pride in their work.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Produces high quality work.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates congruence between statements and actions.
  1. Builds and maintains the trust of others.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Is a person you can trust.
  1. Is trustworthy; is someone I can trust.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Conducts regular performance appraisals and feedback.
  1. Provides clear, motivating, and constructive feedback.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
If [Participant Name] were to make improvements in Coaching, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Understands the processes and various stages of business development.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Seeks and utilizes mentors to help guide professional development.
  1. Takes the initiative to complete tasks.
  1. Finds unique ways to go around barriers to success.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

Fiscal Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Monitors expenses and verifies the need for items purchased.
  1. Keeps excellent records for financial transparency.
  1. Effective in using Company's resources.
  1. Develops budgets and plans for various programs and initiatives.
  1. Provides budgeting and accounting support to the Company.
If [Participant Name] were to make improvements in Fiscal Management, 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.