Others- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Surveys Measuring Others:
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:
Others, Attitude, Leadership, Delegation, Goals, Juggling Multiple Responsibilities, Managing Risk, Trustworthy, Coaching, Recognition, Planning
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


Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Constructively receives criticism and suggestions from others.
  1. Forms working relationships with employees from other departments.
  1. Able to see issues from others' perspectives.
  1. ...treats others with respect and dignity.
  1. Respects the opinions of other employees.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Attitude

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Is gracious and professional in their interactions with others.
  1. Builds open and trusting relationships.
  1. Treats all people fairly and with respect.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets specific, measurable, and challenging goals.
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Clearly explains performance expectations and goals to be reached at the beginning of a project, then let's others decide how to achieve the goal.
  1. Demonstrates leadership and courage in critical situations.
  1. Sits down regularly with employees to review their job performance.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Delegation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Assigns tasks to create learning opportunities for the employees.
  1. Allows employees to decide how they wish to complete the tasks.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
If [Participant Name] were to make improvements in Delegation, what are your suggestions for how he/she can improve this?

Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Establishes and documents goals and objectives.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Understands & contributes to development of strategic goals.
  1. Achieves established goals.
If [Participant Name] were to make improvements in Goals, what are your suggestions for how he/she can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Switches attention to more urgent tasks when necessary.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Spends the most time and effort on critical tasks first.
  1. Assigns tasks based on skills of team members.
  1. Keeps track of multiple assignments and deadlines.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Managing Risk

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Identifies and mitigates risks while making informed, strategic decisions.
  1. Evaluates risks against acceptable risk levels.
  1. Creates informative guides regarding potential risks and risky behaviors.
  1. Understands the possible financial risks of different events.
  1. Adopts a risk-based approach to establishing systems of internal controls.
If [Participant Name] were to make improvements in Managing Risk, what are your suggestions for how he/she can improve this?

Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is a person you can trust.
  1. Delivers on promises made.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Consistently keeps commitments.
  1. Works in a way that makes others want to work with her/him.
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. Provides clear, motivating, and constructive feedback.
  1. Conducts regular performance appraisals and feedback.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  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?

Recognition

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Offers recognition in a timely manner.
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Lets employees know when they have done well
  1. Finds opportunities to recognize others.
  1. Is sincerely interested in the suggestions of co-workers
If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?

Planning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Anticipates challenges and has plans to overcome them.
  1. Develops plans to help manage expectations and project demands.
  1. Prioritizes tasks based on urgency/need.
  1. Determines staffing needs for the project/department.
  1. Able to develop logistics plans to move material through a multi-step supply chain.
If [Participant Name] were to make improvements in Planning, 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.