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)
Survey 13 (4-point scale; numbers)
Survey 14 (4-point scale; N/A)
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.

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. I systematically and thoroughly inspect products for consistency in meeting specifications.
  1. I create a culture of quality standards in the workplace.
  1. You hold employees accountable for your quality of work.
  1. I create quality improvement programs and processes.
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. You take action to establish clear and concise deadlines for tasks to be completed.
  1. You take decisive action to address problems, following up with relevant team members and coaching them on how to improve.
  1. You coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. I am able to initiate work on projects independently without direct supervision.
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 create a lot of new ideas.
  1. You add value to the department/organization.
  1. You inspire creativity in your team.
  1. You conceive, implement and evaluate ideas.
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. I gladly accept new challenges and work on them with urgency.
  1. You fixe problems when they occur.
  1. I convert plans into actions.
  1. You work quickly when faced with difficult problems.
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 assign additional responsibilities to facilitate internal employee promotions.
  1. You require employees to participate in additional job training as part of a remediation program.
  1. You recognize employees with a long and distinguished career of service.
  1. I monitor progress to ensure performance goals are being met.
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 identifiy opportunities for progress and innovation.
  1. You implement data validation techniques and methods.
  1. You use appropriate techniques to solve problems.
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 coordinate the work of a team by assigning tasks to other team members.
  1. You avoid bottlenecks in progress by assigning multiple individuals to critical tasks.
  1. You assess current capabilities before committing to new requests from customers.
  1. You switch attention to more urgent tasks when necessary.
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 take a lot of pride in your work.
  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 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. You promote, implement, maintain and enhances relationships with customers.
  1. I am competent in handling difficult customers.
  1. You document customer interactions.
  1. You use feedback from customers to help improve services.
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 allow employees the freedom to do tasks how they see fit, but hold them accountable for obtaining results.
  1. You avoid micromanaging your employees.
  1. You trust employees are able to complete assigned tasks.
  1. I value the expertise that others bring to the team.
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 avoid engaging in conflicts over minor workplace matters.
  1. You establish roles and responsibilities of team members.
  1. I seek to avert the recurrence of conflict issues.
  1. I address concerns about the availability of limited resources.
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 provide assistance and support to other team members when needed
  1. I listen to other team members without interrupting them.
  1. You share pertinent information with all members of the team.
  1. You appreciate the input from other 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.