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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)
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:
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
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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. Works across boundaries within the organization.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Treats others with respect and dignity.
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. Shows by their actions that they trust in the positive intentions of others.
  1. Builds open and trusting relationships.
  1. Visibly supports and encourages diversity in style and background.
  1. Treats all people fairly and with respect.
  1. Contributes to a positive and fun work environment.
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. Able to influence others.
  1. Sets a high level of performance expectations and challenges others to do the same.
  1. Expresses clear goals and objectives.
  1. Motivates others to reach and exceed organizational goals and objectives.
  1. Able to align manpower, design work, an allocate tasks to achieve goals.
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. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Clearly defines duties and tasks to be completed.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Assigns tasks to create learning opportunities for the employees.
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. Goal Setting
  1. Achieves goals.
  1. Understands & contributes to development of strategic goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  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. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Coordinates the work of a team by assigning tasks to other team members.
  1. Begins tasks as soon as possible.
  1. Switches attention to more urgent tasks when necessary.
  1. Plans and organizes continuously while performing all other responsibilities and activities.
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. Accurately perceives potential risks in the workplace and initiates preventative measures.
  1. Implements changes to reduce the chances of critical incidents in the future.
  1. Committed to implementing rules and procedures to minimize risk.
  1. Takes calculated risks by effectively recognizing and managing them.
  1. Uses risk data to generate insights and drive strategic decisions.
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. Demonstrates congruence between statements and actions.
  1. Is a person you can trust.
  1. Takes care to maintain confidential information.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  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. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Develops the skills and capabilities of others.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Addresses employee behavior problems effectively.
  1. Helps employees to maintain high personal standards.
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. Compliments other people when they do good work
  1. Offers recognition in a timely manner.
  1. Recognizes the abilities and skills of self and others
  1. Recognizes team members who offer a significant contribution to a project.
  1. Lets employees know when they have done well
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. Establishes and monitors timeframes and timelines.
  1. Is good at planning for the "unexpected".
  1. Develops a strategic plan to reduce costs in the department.
  1. Encourages others to follow the plan.
  1. Effectively uses logistics planning to reduce supply delays.
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.