Innovation - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Innovation:
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:
Innovation, Achievement, Adaptability, Action, Continual Learning, Leadership, Managing Performance, Performance, Interpersonal Skills, Coaching, Entrepreneurship
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


Innovation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Fosters a creative and innovative work environment.
  1. Creates improved methods or solutions for meeting goals and objectives.
  1. Builds upon the ideas and solutions of others.
  1. Implements best practices within the department.
  1. Suggests new ideas at meetings.
If [Participant Name] were to make improvements in Innovation, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Increased customer satisfaction scores for the quarter.
  1. Accepts setbacks and challenges as improvement opportunities
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Improved the quality of work on the production line.
  1. Establishes stretch goals to advance skills and output.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Works effectively with various personalities of team members.
  1. Adjusts plans to meet the needs of new constraints.
  1. Handles unexpected events without a loss of productivity.
  1. Effective in working with different personnel of the team.
  1. Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is not afraid to take corrective action when necessary.
  1. Does not procrastinate when there is a job to be done.
  1. Anticipates needs and takes pre-emptive action to address the issue.
  1. Conducts critical-incident review immediately after the event.
  1. Undertakes actions to achieve specific goals.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Pursues self-improvement through continual learning.
  1. Takes the initiative to learn new skills.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Improves on their skill sets.
  1. Pursues learning that will enhance job performance.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is a highly effective supervisor.
  1. Able to align manpower, design work, an allocate tasks to achieve goals.
  1. Sets specific, measurable, and challenging goals.
  1. Acts decisively in implementing decisions.
  1. Gives inspiring presentations or discussions.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Managing Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Places employees on probation if they fail to meet minimum performance standards.
  1. Stresses the importance of meeting production quotas.
  1. Informs team members how their performance compares to stated goals.
  1. Reviews monthly or weekly reports of quantitative metrics (sales/production) to measure performance level.
  1. Administers the performance rewards program in a fair and equitable manner.
If [Participant Name] were to make improvements in Managing Performance, what are your suggestions for how he/she can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Has great overall performance
  1. Effectively organizes resources and plans
  1. Works effectively in the department.
  1. Able to organize work.
  1. Sets a high standard for job performance.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Values the opinions of others.
  1. Gives good advice and suggestions to coworkers.
  1. Easily approachable.
  1. Considers the other individual's point of view.
  1. Recognizes the contributions of others.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?

Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Helps employees to maintain high personal standards.
  1. Develops the skills and capabilities of others.
  1. Meets regularly with employees to coach them on areas that will enhance their 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. Finds unique ways to go around barriers to success.
  1. Takes the initiative to complete tasks.
  1. Seeks and utilizes mentors to help guide professional development.
  1. Encourages dynamic growth opportunities.
  1. Balances risks and rewards when making decisions.
If [Participant Name] were to make improvements in Entrepreneurship, 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.