Recognition- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Surveys Measuring Recognition:
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:
Recognition, Attitude, Creativity, Self Management, Supervisory Skills, Clarity, Responsible, Customer Focus, Conflict Management, Planning
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


Recognition

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Recognizes the abilities and skills of self and others
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Recognizes team members who offer a significant contribution to a project.
  1. Says "thank you" to show appreciation for work of others.
  1. Offers recognition in a timely manner.
If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?

Attitude

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Contributes to a positive work environment.
  1. Is gracious and professional in their interactions with others.
  1. Contributes to a positive and fun work environment.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Visibly supports and encourages diversity in style and background.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?

Creativity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Adds value to the department/organization.
  1. Creates a lot of new ideas.
  1. Develops solutions to challenging problems.
  1. Is creative and inspirational.
  1. Inspires creativity in their team.
If [Participant Name] were to make improvements in Creativity, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Supervisory Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Communicates on a daily basis with the team at the start of each shift.
  1. Spends time to actively listen to the grievance.
  1. Conducts regular progress meetings to ensure adherence to the schedule.
  1. Delegates effectively.
  1. Implements disciplinary policy in accordance with the union contract
If [Participant Name] were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?

Clarity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Clearly explains the vision and goals of the company.
  1. Avoids stating unclear or conflicting goals.
  1. Communicates with clarity and efficiency.
  1. Adjusts communication methods to the needs of the audience.
  1. Clearly defines work objectives for employees.
If [Participant Name] were to make improvements in Clarity, what are your suggestions for how he/she can improve this?

Responsible

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is a person you can trust.
  1. Sets a good example
  1. Sets high personal standards of performance.
  1. Holds herself / himself accountable to goals / objectives
  1. Completes assigned work tasks.
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Customer Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Prioritizes customer issues to tackle the most pressing needs first.
  1. Anticipates potential obstacles to meeting customer needs.
  1. Obtains feedback to ensure customer needs are being met.
  1. Maintains strong relationships with customers.
  1. Is committed to the success of the customer.
If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?

Conflict Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Assists team members by helping them see the other point of view.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Deals effectively with employee grievances.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Discusses conflict situations with supervisor.
If [Participant Name] were to make improvements in Conflict Management, what are your suggestions for how he/she can improve this?

Planning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Initiates the planning process by defining the scope of the project.
  1. Conducts regular assessments of the project status to ensure adherence to the set schedule.
  1. Closely follows the plan established for the department.
  1. Develops plans used to accomplish urgent or critical tasks.
  1. Develops plans to help manage expectations and project demands.
If [Participant Name] were to make improvements in Planning, 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.