HR-Survey > 360-Degree Feedback > Competency Model > Initiative

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)
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:
Initiative, Juggling Multiple Responsibilities, Adaptability, Self Management, Leadership, Achievement, Excellence, Trustworthy, Coaching, Entrepreneurship, Fiscal Management
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. Initiates new projects for the department.
  1. Takes action without being asked.
  1. Anticipates problems and initiates plans to address them.
  1. Is proactive and gets things done.
  1. Takes on additional tasks without being asked or told to do so.
  1. Does things without being told.
  1. Acts with urgency when time is limited.
  1. Prepares for unexpected contingencies.
  1. Takes advantage of opportunities when they become available.
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. Ranks the importance of tasks to make sure critical tasks are completed first.
  1. Completes multiple tasks simultaneously.
  1. Can multitask while performing all of their other responsibilities and activities.
  1. Organizes tasks for the most efficient order of completion.
  1. Builds in extra time in the schedule for unplanned events/occurrences.
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. Is open to new ideas and innovations.
  1. Adjusts to the new vision and mission of the company.
  1. Adjusts plans as needed based on changing conditions.
  1. Adjusts priorities to changing business goals.
  1. Is proactive and takes steps to prepare for changes in the workplace.
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. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Does not allow own emotions to interfere with the performance of others.
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. Motivates and challenges employees to attain a shared vision.
  1. Demonstrates leadership and courage in critical situations.
  1. Provides resources to enable individuals to develop professionally.
  1. Is a highly effective supervisor.
  1. Recognizes individual and team accomplishments and reward them appropriately.
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. Improved the quality of work on the production line.
  1. Strives to exceed standards of performance.
  1. Increased revenue for the company.
  1. Is flexible in adjusting priorities to meet the demands of changing situations.
  1. Driven to complete goals despite obstacles that may arise.
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. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Takes a lot of pride in their work.
  1. Is planful and organized.
  1. Keeps themselves and others focused on constant improvement.
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. Delivers on promises made.
  1. Takes care to maintain confidential information.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Works in a way that makes others want to work with her/him.
  1. Takes ownership, delivers on commitments
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. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Helps employees to maintain high personal standards.
  1. Provides clear, motivating, and constructive feedback.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Addresses employee behavior problems effectively.
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. Balances risks and rewards when making decisions.
  1. Is comfortable operating in an environment of uncertainty.
  1. Exhibits determination and passion in completion of goals.
  1. Devotes a certain amount of time and effort to developing new business opportunities.
  1. Has a strategic awareness on how to promote the organization.
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. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Effective in using Company's resources.
  1. Monitors expenses and verifies the need for items purchased.
  1. Monitors spending.
  1. Develops of the department's annual budget.
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.