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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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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
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Recognition

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Finds opportunities to recognize others.
  1. Says "thank you" to show appreciation for work of others.
  1. Offers recognition in a timely manner.
  1. Compliments other people when they do good work
  1. Makes people around them feel appreciated and valued.
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. Visibly supports and encourages diversity in style and background.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Contributes to a positive work environment.
  1. Builds open and trusting relationships.
  1. Treats all people fairly and with respect.
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. Creates a lot of new ideas.
  1. Is creative.
  1. Inspires creativity in their team.
  1. Develops solutions to challenging problems.
  1. Adds value to the department/organization.
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. Analyzes interpersonal problems instead of reacting to them.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Steps away from a situation to process appropriate response.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
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. Decides what supplies need to be purchased.
  1. Values the opinions of subordinates.
  1. Adopts a measured approach to resolving workplace issues, ensuring that actions are not taken hastily.
  1. Follows the company standard procedures for allocating assignments.
  1. Instructs employees on the safest way to perform tasks.
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. Provides a clear vision for the future.
  1. Is clear about goals that need to be achieved.
  1. Writes clear job descriptions for positions in the organization.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Communicates with clarity and efficiency.
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. Responsible for setting the vision of the department.
  1. ...takes personal responsibility for results.
  1. Sets a good example
  1. Works in a way that makes others want to work with her/him.
  1. Behavior is ethical and honest.
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. Is aware of the customer's needs.
  1. Creates innovative solutions for the customers.
  1. Looks for opportunities that have a positive impact on customers.
  1. Anticipates resources needed to meet the customer needs.
  1. Manages customer accounts with high degree of competence.
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. Promotes mutual compromise to achieve conflict resolution.
  1. Shares competing viewpoints to expand viewpoints.
  1. Views conflicts as opportunities to create constructive and novel solutions to problems.
  1. Ensures that the basic needs of each party are satisfied.
  1. Guides others toward establishing strong relationships.
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. Delegates role to team members to accomplish goals.
  1. Ensures staff are held accountable for following the department plan.
  1. Accurately estimates the amount of materials/supplies needed for the project.
  1. Determines the steps required for completion of a task.
  1. Develops plans to ensure the smooth operation of the supply chain.
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.