Initiative - 360 Degree Feedback Survey Sample #2





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)
Survey 14 (4-point scale; N/A)
Instructions

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 and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Completes tasks without having to be told to do so.
  1. Goes above and beyond the stated goals.
  1. Immediately informs the HR Department of any personnel complaints or issues.
What are your suggestions for how [Participant Name] can make improvements
in Initiative?

Goals

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Makes sure that I have a clear idea of our group's goals.
  1. Achieves goals.
  1. Establishes and documents goals and objectives.
  1. Goal Setting
What are your suggestions for how [Participant Name] can make improvements
in Goals?

Results Oriented

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Determined to complete tasks regardless of obstacles that may occur.
  1. Exceeds performance requirements.
  1. Strives to achieve high volume of output.
  1. Has a strong result orientation.
What are your suggestions for how [Participant Name] can make improvements
in Results Oriented?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is clear about the roles and duties of team members.
  1. Makes sure employees understand why they were given certain assignments.
  1. Clarifies problems and their causes to help employees correct them.
  1. Clearly defines work objectives for employees.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Creates a lot of new ideas.
  1. Develops solutions to challenging problems.
  1. Conceives, implements and evaluates ideas.
  1. Is creative.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Professional Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Contributing fully to the extent of their skills
  1. Seeks opportunities for continuous learning.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Keep themselves up-to-date of technical/professional issues
What are your suggestions for how [Participant Name] can make improvements
in Professional Development?

Punctuality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Responds to requests for information in a timely manner.
  1. Starts meetings on time.
  1. Arrives to meetings on time.
  1. Invoices clients on a timely basis.
What are your suggestions for how [Participant Name] can make improvements
in Punctuality?

Managing Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ensures the employee understands the key tasks, goals and KPIs required for the position.
  1. Initiates probationary actions for employees with sub-par performance.
  1. Routinely holds audits of performance on a weekly or monthly basis.
  1. Ensures employees understand how work is to be completed.
What are your suggestions for how [Participant Name] can make improvements
in Managing Performance?

Quality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ensures the hiring of employees that have a quality focus.
  1. Develops measures of the success of quality initiatives.
  1. Recognizes their role in promoting quality and safety in the workplace.
  1. Establishes timeframes for achieving suitable quality levels.
What are your suggestions for how [Participant Name] can make improvements
in Quality?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes immediate action on poor performance
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Prefers to resolve conflicts through negotiation rather than coersion.
  1. Seeks to reduce the scarcity of limited resources by sourcing materials from new locations.
  1. Values the diverse perspectives of others.
  1. Persuades others to accept personal transformation.
What are your suggestions for how [Participant Name] can make improvements
in Conflict Management?

Planning

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Anticipates obstacles and ways to overcome them.
  1. Determines the amount of materials/supplies needed for the project.
  1. Regularly makes plans for contingencies.
  1. Creates a timeline for events and monitors progress.
What are your suggestions for how [Participant Name] can make improvements
in Planning?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.