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. Lets employees know when they have done well
  1. Recognizes the abilities and skills of self and others
  1. Says "thank you" to show appreciation for work of others.
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Recognizes individuals for a specific outstanding achievement.
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. Builds open and trusting relationships.
  1. Is gracious and professional in their interactions with others.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Visibly supports and encourages diversity in style and background.
  1. Contributes to a positive work environment.
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. Is creative.
  1. Inspires creativity in their team.
  1. Is creative and inspirational.
  1. Conceives, implements and evaluates ideas.
  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. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Analyzes interpersonal problems instead of reacting to them.
  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.
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. Listens to the concerns of employees.
  1. Provides feedback referencing specific instances or examples of behaviors.
  1. Schedules follow up meetings if employee's performance is below average.
  1. Is a calming force during stressful periods.
  1. Completes assessments in a timely manner.
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. Clarifies problems and their causes to help employees correct them.
  1. Avoids stating unclear or conflicting goals.
  1. Adjusts communication methods to the needs of the audience.
  1. Clearly defines work objectives for employees.
  1. Clearly explains the vision and goals of the company.
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. Behavior is ethical and honest.
  1. Sets a good example.
  1. Sets a good example
  1. Is a person you can trust.
  1. Works in a way that makes others want to work with her/him.
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. Actively listens to concerns from customers.
  1. Satisfies customer needs.
  1. Is pro-active in dealing with customers and addressing their needs.
  1. Interacts with customers to define roles, expectations, and responsibilities.
  1. Is consistent in services provided to customers.
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. Shares competing viewpoints to expand viewpoints.
  1. Persuades individuals to alter their underlying work behaviors which may have led to the conflict.
  1. Actively engages both parties to voluntarily collaborate and resolve their differences.
  1. Settles disputes with agreement from both parties.
  1. Sees conflicts as chances to develop innovative and effective solutions.
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. Develops plans used to accomplish urgent or critical tasks.
  1. Is able to clearly articulate the plan for the department/district.
  1. Develops a strategic plan to reduce costs in the department.
  1. Determines the appropriate actions needed to achieve goals.
  1. Assesses the risks of various strategic plans.
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.