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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; floating anchors)
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.

Competencies Included:
Initiative, Goals, Results Oriented, Clarity, Creativity, Professional Development, Punctuality, Managing Performance, Quality, Co-worker Development, Conflict Management, Planning
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.
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Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Confronts problems immediately without supervisor instructions.
  1. Creates solutions to problems as soon as an incident occurs.
  1. When working on a problem in a team, they are often the first to suggest possible solutions.
  1. Sees what needs to be done and takes appropriate actions.
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. Focuses on actions that actively contribute to achieving the goal.
  1. Clearly articulates ambitious goals that are within reach.
  1. Aids colleagues in achieving their performance metrics.
  1. Sets goals for themselves professionally.
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. Encourages open dialogue to surface new ideas and pivot strategies collaboratively.
  1. Steps in to cover responsibilities during peak workloads or staff shortages.
  1. Encourages employees to give 100% to achieving high results.
  1. Focuses on achieving important goals.
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. Communicates with clarity and efficiency.
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Maintains clarity in goals and objectives.
  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. Identifies creative opportunities to optimize operations.
  1. Invents novel approaches that challenge standard practices.
  1. Acknowledges both the good and the bad parts of newly created ideas/products.
  1. Brings a unique creative lens to problem-solving and planning.
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. Seeks opportunities for continuous learning.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Encourages employees to take courses relevant to their job.
  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. Conducts appointments at scheduled start time.
  1. Arrives to meetings on time.
  1. Starts the workday when scheduled.
  1. Avoids making personal phone calls during working hours.
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 team members receive rewards for positive performance accomplishments.
  1. Uses existing performance frameworks to define measures of performance.
  1. Provides employees with necessary resources to accomplish their goals.
  1. Aligns individual and team goals with the organization's goals and objectives.
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. Creates quality improvement programs and processes.
  1. Ensures the hiring of employees that have a quality focus.
  1. Verifies the operators have the necessary equipment and supplies to ensure high quality.
  1. Effectively works with Quality Control (QC) engineers.
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. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Takes immediate action on poor performance
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Works to identify root causes of performance problems
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. Explores the feasibility of alternative solutions to resolve conflicts.
  1. Shares competing viewpoints to expand viewpoints.
  1. Creates an atmosphere of consensus and mutual respect to facilitate conflict resolution.
  1. Avoids premature conclusions, allowing space for nuance and deeper understanding.
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. Schedules staff based on seasonal needs.
  1. Prioritizes plans based on a cost/benefit analysis.
  1. Assesses the risks of various strategic plans.
  1. Sets the appropriate sequence of tasks to ensure completion of the project.
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.