Quality - 360 Degree Feedback Survey Sample #2





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)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. 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 as an employee over the last twelve months and the goals you were asked to achieve. 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Quality, Initiative, Creativity, Action, Managing Performance, Analytical, Juggling Multiple Responsibilities, Excellence, Customer Focus, Empowering Others, Conflict Management, Teamwork
Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Quality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You establish timeframes for achieving suitable quality levels.
  1. You analyze what occurred and re-adjusts accordingly when goals are not met.
  1. You make sure cleanliness standards are met to reduce the possibility of contamination.
  1. I effectively coordinate with other departments to improve quality.
What are your suggestions for how you can make improvements
in Quality?

Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I look for opportunities to move projects forward.
  1. I take advantage of opportunities when they become available.
  1. I initiate important conversation topics at meetings.
  1. I expand the offerings of the department by working evenings and weekends.
What are your suggestions for how you can make improvements
in Initiative?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are creative and inspirational.
  1. You create a lot of new ideas.
  1. You inspire creativity in your team.
  1. You are creative.
What are your suggestions for how you can make improvements
in Creativity?

Action

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You prepare equipment at the start of the shift.
  1. I take preemptive actions avoid obstacles or delays.
  1. I rapidly adapt to changes in the situation.
  1. I take the initiative to address problems sooner rather than later.
What are your suggestions for how you can make improvements
in Action?

Managing Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You set long and short term goals.
  1. I establish indicators to measure levels of performance.
  1. You ensure employees understand their performance expectations.
  1. You acknowledge employee contributions that support the bottom line.
What are your suggestions for how you can make improvements
in Managing Performance?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You identify the root cause of a problem.
  1. You analyze issues and reduce them to their component parts.
  1. You balance risks and costs with the reward and probabilities of success when decisions.
  1. You identify problems and issues needing resolution.
What are your suggestions for how you can make improvements
in Analytical?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You organize tasks for the most efficient order of completion.
  1. You determine which tasks are critical and which tasks are optional.
  1. You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
What are your suggestions for how you can make improvements
in Juggling Multiple Responsibilities?

Excellence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You demonstrate the functional or technical skills necessary to do your job.
  1. You keep yourself and others focused on constant improvement.
  1. You take a lot of pride in your work.
  1. You can be counted on to add value wherever you are involved.
What are your suggestions for how you can make improvements
in Excellence?

Customer Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I provide training to others on how to improve customer service.
  1. I am competent in handling customer cases.
  1. I respond to feedback from customers.
  1. You consistently model positive customer service attitudes.
What are your suggestions for how you can make improvements
in Customer Focus?

Empowering Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I view others in the department as valued assets to be trained and employed.
  1. You are aware of the skill levels of employees and assign tasks that are at the appropriate skill level.
  1. I encourage employees to take the initiative when responding to an issue.
  1. You give employees input into the decision making process.
What are your suggestions for how you can make improvements
in Empowering Others?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I steer the process towards compromise and conflict resolution.
  1. I help to maintain dignity of all persons involved.
  1. I promote openness and urge individuals to explore various options for resolving the conflict.
  1. You share competing viewpoints to expand viewpoints.
What are your suggestions for how you can make improvements
in Conflict Management?

Teamwork

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You give constructive advice to other team members.
  1. I focus on understanding the other team member's message.
  1. I facilitate effective decision-making practices to further develop the team.
  1. I build strong relationships with team members.
What are your suggestions for how you can make improvements
in Teamwork?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.