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)
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


Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Effectively organizes resources and plans
  1. ...Overall Performance
  1. Has great overall performance
  1. Shown significant improvement in job performance.
  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?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps others to improve or meet standards of performance.
  1. Takes calculated risks to achieve higher levels of performance.
  1. Improved the quality of work on the production line.
  1. Set high standards in their performance
  1. Increased customer satisfaction scores for the quarter.
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. Encourages employees to expand their skills in order to take on greater responsibilities.
  1. Trusts employees to complete tasks assigned.
  1. Acknowledges and appreciates employees for their proactive decision-making.
  1. Ensures employees understand what is being assigned to them.
  1. Lets employees make their own decisions.
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. Facilitates effective teamwork during periods of change.
  1. Supports open communication between team members.
  1. Finds opportunities to recognize and reward team members.
  1. Helps the team decide what long term goals need to be met.
  1. Works cooperatively with others to solve problems.
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. Is open to change and adjusts plans when needed.
  1. Adjusts to the new vision and mission of the company.
  1. Will stop what they are doing to help colleagues in need.
  1. Able to respond to incidents without stopping the workflow.
  1. Adjusts plans to meet the needs of new constraints.
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. Creates innovative products and services.
  1. Works across organizational lines and boundaries to attain goals.
  1. Approves purchase requests in a timely manner.
  1. Takes responsibility for actions.
  1. Makes decisions confidently and stands by them.
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. Takes charge of their training and skills enhancement.
  1. Participates in regular training offered.
  1. Pursues self-improvement through continual learning.
  1. Pursues professional development opportunities when they arise.
  1. Improves on their skill sets.
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. Effectively leads others.
  1. Highly effective supervisor.
  1. Guides decision-making by coaching, counseling and rewarding.
  1. Sets clear goals and objectives for subordinates.
  1. Demonstrates leadership and courage in critical situations.
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. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Impresses upon others the important aspects of [Company].
  1. Understands the use of [Company] products and services.
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. Identifies emerging trends and anticipates future market shifts.
  1. Builds a culture that reinforces the manager's vision.
  1. Creates a positive vision of the future for the Company.
  1. Devoted to carrying out the strategic vision.
  1. Develops a vision that is a catalyst for innovation and change.
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.