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Performance - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Performance:
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:
Performance, Achievement, Empowering Others, Teamwork, Adaptability, Action, Continual Learning, Leadership, Company, Vision
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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Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Effectively organizes resources and plans
  1. Listens and responds to issues and problems
  1. Works effectively in the department.
  1. Works well in this position.
  1. Shown significant improvement in job performance.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Moves decisively in high-risk situations to secure long-term achievements.
  1. Demonstrates a sense of urgency to quickly and accurately solve problems and issues.
  1. Maintains unwavering commitment to goals.
  1. Sets challenging goals for the department.
  1. Completed required training and certification.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Allows employees to make their own decisions.
  1. Recognizes the expertise that employees have in certain areas and allows them the freedom to operate as they see fit.
  1. Allows employees to participate in the workload of the department.
  1. Avoids micromanaging their employees.
  1. Recognizes the accomplishments of employees when they complete important assignments.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Shares resources and information with the team.
  1. Helps the team decide what long term goals need to be met.
  1. Helps other team members to research solutions to a problem.
  1. Fosters teamwork rather than individual competition
  1. Encourages collaboration with other departments.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Learns from personal experiences and/or mistakes.
  1. Takes decisive action to alter course when needed.
  1. Works effectively in dynamic and changing work environments.
  1. Integrates new core values of the company.
  1. Can take on new assignments.
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. Addresses safety issues immediately.
  1. Fixes small issues before they become critical incidents.
  1. Creates opportunities and then takes advantage of them.
  1. Is not afraid to take corrective action when necessary.
  1. Anticipates critical incidents in the department and takes steps to mitigate their effect.
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. Participates in regular training offered.
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Improves on their skill sets.
  1. Takes the initiative to learn new skills.
  1. Pursues self-improvement through continual learning.
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. Provides positive reinforcement and honest feedback to subordinates.
  1. Sets goals and objectives that exceed those of peers or team members.
  1. Provides clear directions for others to follow.
  1. Consistently follows commitments in dealing with others
  1. Listens actively to employee perspectives during feedback discussions.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Company

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Implements fair and equitable time and attendance policies.
  1. Has created an excellent training and development department.
  1. Establishes a work environment where employees can concentrate without frequent interruptions.
  1. Treats all employees equitably, regardless of role, background, or tenure.
  1. Communicates long-term goals with enthusiasm and clarity, helping employees see what's possible.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

Vision

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Fosters a leadership vision that promotes innovation and growth.
  1. Leads with a growth-oriented mindset, driving innovation and expansion.
  1. Channels team activities towards the vision's core aspects.
  1. Creates a timeline to fulfill the organization's vision.
  1. Recognizes potential challenges and devises comprehensive strategies to navigate and mitigate these difficulties.
If [Participant Name] were to make improvements in Vision, 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.