Quality - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Quality:
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:
Quality, Integrity, Continual Learning, Leadership, Persuasion and Influence, Technical, Interpersonal Skills, Developing Others, Others, Entrepreneurship, Global Perspective
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


Quality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Encourages others to produce the highest quality work products.
  1. Always strives to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.
  1. Encourages others to achieve high quality standards.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
If [Participant Name] were to make improvements in Quality, what are your suggestions for how he/she can improve this?

Integrity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates honesty and truthfulness at all times.
  1. Protects the integrity and confidentiality of information
  1. Develops trust and confidence from others.
  1. Does what was promised.
  1. Fosters a high standard of ethics and integrity.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Pursues learning that will enhance job performance.
  1. Views setbacks as opportunities to learn from.
  1. Builds on their strengths while addressing their weaknesses.
  1. Sets relevant learning objectives and goals.
  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. Takes ownership and accountability for results
  1. Sets a high level of performance expectations and challenges others to do the same.
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Guides decision-making by coaching, counseling and rewarding.
  1. Acts decisively in implementing decisions.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Persuasion and Influence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Communicates effectively with others.
  1. Ensures stakeholders are involved in the decision making process.
  1. Able to express own goals and needs.
  1. Develops a good rapport with others.
  1. Attempts to persuade others rather than simply control them.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?

Technical

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Willingly shares information and expertise; sought out as resource by others
  1. Knows how to produce high quality products/work.
  1. Demonstrates mastery of the technical competencies required in his/her work.
  1. Willingly shares his/her technical expertise; sought out as resource by others
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
If [Participant Name] were to make improvements in Technical, what are your suggestions for how he/she can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Gives good advice and suggestions to coworkers.
  1. Strives for win/win solutions
  1. Honesty and integrity are core tenets of interpersonal relationships.
  1. Assists those in the department who need help in meeting performance metrics.
  1. Is someone you can trust.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is open to receiving feedback.
  1. Assesses employees' developmental needs.
  1. Recognizes and celebrates accomplishments of others.
  1. Supports the successes of other employees.
  1. Tries to ensure employees are ready to move to the next level.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to see issues from others' perspectives.
  1. Includes others in the decision making processes.
  1. Forms working relationships with employees from other departments.
  1. Is able to see issues from others' perspectives.
  1. Works across boundaries within the organization.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Seeks and utilizes mentors to help guide professional development.
  1. Can work effectively in an environment of uncertainty.
  1. Excellent at managing relationships with stakeholders.
  1. Encourages risk taking for developing potential business opportunities.
  1. Is comfortable operating in an environment of uncertainty.
If [Participant Name] were to make improvements in Entrepreneurship, what are your suggestions for how he/she can improve this?

Global Perspective

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Forms strong client relationships with international partners.
  1. Builds working relationships with others across cultures.
  1. Accepts setbacks and challenges in foreign markets as improvement opportunities
  1. Understands how cultures differ and how these differences impact work behavior.
  1. Applies knowledge of overseas markets.
If [Participant Name] were to make improvements in Global Perspective, 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.