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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; floating anchors)
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.

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.
Edit this Survey
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Quality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You develop specific quality standards/goals to be met within a specified timeframe.
  1. You are innovative and creative in response to issues involving quality of the products.
  1. You are able to create quality initiatives to be implemented organization-wide.
  1. I quickly address changes in quality of the products.
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 act with urgency when time is of the essence.
  1. I look to start work on new projects without waiting for direction from the manager.
  1. I initiate projects that have an impact on the department.
  1. You guide strategic initiatives to advance the department/organization.
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 add value to the department/organization.
  1. You are creative.
  1. You inspire creativity in your team.
  1. You create a lot of new 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. You work across organizational lines and boundaries to attain goals.
  1. I do not procrastinate when there is a job to be done.
  1. You approve purchase requests in a timely manner.
  1. I am proactive rather than reactive in work.
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. I conduct objectives and key results (OKR) assessments on a quarterly basis.
  1. I communicate OKRs to employees regularly during monthly meetings.
  1. I monitor progress to ensure performance goals are being met.
  1. I establish indicators to measure levels of performance.
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 create new visualizations of the data.
  1. I help employees see that changes in one part of the business can affect other parts.
  1. You identify deviations from stated goals and objectives.
  1. I employ data and logic to counter personal biases of others.
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 rank the importance of tasks to make sure critical tasks are completed first.
  1. You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. You can multitask while performing all of your other responsibilities and activities.
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 produce high quality work.
  1. You demonstrate the analytical skills to do your job.
  1. You are planful and organized.
  1. You keep yourself and others focused on constant improvement.
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 ensure all customer commitments and requirements are met or exceeded.
  1. You follow up with any unanswered questions from the customer.
  1. I respond to feedback from customers.
  1. I build products that meet the unique needs of each customer.
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 encourage employees to make informed decisions based on their own judgment and reasoning.
  1. You recognize the contributions that others make to the department.
  1. You provide support and resources needed to accomplish goals.
  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 possess the necessary skills to manage conflict and relationships.
  1. I seek to avert the recurrence of conflict issues.
  1. I help to maintain dignity of all persons involved.
  1. I listen to individuals as they offer their unique perspectives on the situation.
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 seek and listen to other's contributions
  1. You create a culture that fosters and values collaboration.
  1. You coach team members to work toward a common goal.
  1. You join with other team members to brainstorm solutions to the problem.
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.