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.

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.


Results Oriented

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Works hard despite obstacles that impede progress.
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Determines the best approach to achieving the expected results.
  1. Sets challenging goals to be achieved.
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. Undertakes actions to achieve specific goals.
  1. Anticipates critical incidents in the department and takes steps to mitigate their effect.
  1. Gladly accepts new challenges and works on them with urgency.
  1. Makes effective decisions, even when under pressure.
  1. Takes steps to prepare for the start of the project.
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. Selects the appropriate techniques for analysis.
  1. Analyzes issues and reduces them to their component parts.
  1. Implements data validation techniques and methods.
  1. Identifies the root cause of a problem.
  1. Identifies problems and issues needing resolution.
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. Does things without being told.
  1. Immediately works to complete goals well before their deadline.
  1. Analyzes the needs of the situation and acts before being told to do so.
  1. Quickly comes to the aid of those who may need help.
  1. Will continue to work on a problem even in the face of obstacles.
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. Assesses current capabilities before committing to new requests from customers.
  1. Begins tasks as soon as possible.
  1. Organizes tasks for the most efficient order of completion.
  1. Keeps track of multiple assignments and deadlines.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
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. Demonstrates the functional or technical skills necessary to do their job.
  1. Demonstrates the analytical skills to do their job.
  1. Produces high quality work.
  1. Can be counted on to add value wherever they are involved.
  1. Keeps themselves and others focused on constant improvement.
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. Sets and maintains high standards for self and others.
  1. Assesses employee performance against defined standards.
  1. Participates in training as needed to improve job performance.
  1. Rewards individuals who show imagination in developing creative solutions to problems.
  1. Communicates OKRs to employees regularly during monthly meetings.
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. Inspires creativity in their team.
  1. Develops solutions to challenging problems.
  1. Is creative.
  1. Adds value to the department/organization.
  1. Conceives, implements and evaluates ideas.
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. Gives others development opportunities through project assignments and increased job responsibilities
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Takes immediate action on poor performance
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Provides ongoing feedback to co-workers on their development progress
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.