Self-Management - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Self-Management:
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:
Self-Management, Continual Improvement, Emotional Intelligence, Adaptability, Bias for Action, Supervisory Skills, Quality, Time Management, Commitment To Result, Technology Use/Management, Managing Risk, Responsible, Empowering Others, Others, 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


Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Steps away from a situation to process appropriate response.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Continual Improvement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Analyzes processes to determine areas for improvement.
  1. Looks for ways to expand current job responsibilities.
If [Participant Name] were to make improvements in Continual Improvement, what are your suggestions for how he/she can improve this?

Emotional Intelligence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Able to understand others' points of view.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Is able to manage their own emotions.
If [Participant Name] were to make improvements in Emotional Intelligence, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Learns from personal experiences and/or mistakes.
  1. Adapts quickly to new situations.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Able to adjust to changing environments.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Bias for Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Completes a large volume of work.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Motivates others to achieve or exceed goals
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
If [Participant Name] were to make improvements in Bias for Action, what are your suggestions for how he/she can improve this?

Supervisory Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Emphasizes constructive discipline strategies, prioritizing the development and feedback of employees over punitive measures.
  1. Encourages employees to take responsibility for mistakes.
  1. Leads others through their commitment to the department.
  1. Is aware of the unique strengths of each employee.
If [Participant Name] were to make improvements in Supervisory Skills, what are your suggestions for how he/she can improve this?

Quality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is innovative and creative in response to issues involving quality of the products.
  1. Competently and accurately analyzes quality measures.
  1. Implements quality control feedback loops to enhance services and products.
  1. Ensures the hiring of employees who are dedicated to delivering exceptional quality in every aspect of their work.
If [Participant Name] were to make improvements in Quality, what are your suggestions for how he/she can improve this?

Time Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Accurately captures time across various tasks.
  1. Prepares to-do lists for the project tasks.
  1. Processes items in the inbox instead of letting them accumulate.
  1. Avoids being distracted by people who are working at a slower pace.
If [Participant Name] were to make improvements in Time Management, what are your suggestions for how he/she can improve this?

Commitment To Result

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Coordinates all department activities into a cohesive team effort.
  1. Able to focus on a task even when working alone.
  1. Encourages commitment in others to obtain results.
  1. Takes immediate action toward goals.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?

Technology Use/Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Proficient in the use of technical systems and processes.
  1. Maximizes the use of new technology to deliver products and services.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Supports technical training and development of employees.
If [Participant Name] were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?

Managing Risk

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses risk data to generate insights and drive strategic decisions.
  1. Creates a risk profile for projects and teams.
  1. Create continuity plans.
  1. Monitors enterprise risk management activities for their impact and effectiveness on mitigating risks.
If [Participant Name] were to make improvements in Managing Risk, 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. Holds herself / himself accountable to goals / objectives
  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?

Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Enables employees to take on more challenging roles.
  1. Encourages employees to make informed decisions based on their own judgment and reasoning.
  1. Is confident in the abilities of employees assigned important tasks.
  1. Includes others in the decision making process.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Treats others with respect and dignity.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Works across boundaries within the organization.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Planning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Anticipates obstacles and ways to overcome them.
  1. Conducts regular assessments of the project status to ensure adherence to the set schedule.
  1. Effectively uses logistics planning to reduce supply delays.
  1. Determines the steps required for completion of a task.
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.