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Results Oriented - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Results Oriented:
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

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 and the goals they 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 be discussed with the employee to foster growth and on-going development.

Competencies Included:
Results Oriented, Action, Analytical, Initiative, Juggling Multiple Responsibilities, Excellence, Managing Performance, Creativity, Co-worker 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.
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Results Oriented

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Stays focused on meeting the needs of customers.
  1. Excels in dynamic environments.
  1. Identifies what needs to be accomplished.
  1. Follows up on service delivery to confirm expectations were met or exceeded.
  1. Proactively identifies when others need assistance and offers help without being asked.
What are your suggestions for how [Participant Name] can make improvements
in Results Oriented?

Action

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Determines the best person for a specific task within the team.
  1. Takes the initiative to address problems sooner rather than later.
  1. Is decisive when making decisions.
  1. Sets high standards for themselves and others.
  1. Immediately develops alternatives and solutions when presented with a problem or issue.
What are your suggestions for how [Participant Name] can make improvements
in Action?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Checks facts by cross-referencing the evidence with other reliable sources.
  1. Ensures staff records financial transactions accurately and completely.
  1. Ready and capable of exploring alternative viewpoints and strategies.
  1. Ensures that the foundation of an analysis is based on reliable and relevant data.
  1. Makes reasonable decisions about the importance of different sources of information.
What are your suggestions for how [Participant Name] can make improvements
in Analytical?

Initiative

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Volunteers time and effort toward the completion of important goals.
  1. Seizes upon chances to improve the department's prospects.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Informs the manager of any important changes in the equipment operation.
  1. Initiates new projects for the department.
What are your suggestions for how [Participant Name] can make improvements
in Initiative?

Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Determines which tasks are critical and which tasks are optional.
  1. Builds in extra time in the schedule for unplanned events/occurrences.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
What are your suggestions for how [Participant Name] can make improvements
in Juggling Multiple Responsibilities?

Excellence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Can be counted on to add value wherever they are involved.
  1. Keeps themselves and others focused on constant improvement.
  1. Takes a lot of pride in their work.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Is planful and organized.
What are your suggestions for how [Participant Name] can make improvements
in Excellence?

Managing Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Uses weekly staff meetings to assess performance of key responsibilities.
  1. Makes sure commitments are understood and met.
  1. Ensures employees understand their performance expectations.
  1. Establishes indicators to measure levels of performance.
  1. Gives additional responsibilities to individuals who exceed standards.
What are your suggestions for how [Participant Name] can make improvements
in Managing Performance?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Able to generate new ideas and think outside the box.
  1. Produces novel and valuable solutions to problems.
  1. Develops solutions to challenging problems.
  1. Leads by example with imaginative thinking and innovative action.
  1. Uses knowledge and problem solving to find creative solutions.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Works to identify root causes of performance problems
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Takes immediate action on poor performance
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.