Strategic Insight- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Surveys Measuring Strategic Insight:
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 for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. 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 over the last 12 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 combined with the responses received from others and a report will be generated for you 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.

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


Strategic Insight

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I attend industry conferences to gain further insight into how other companies deal with similar issues.
  1. I create a vision for the organization based on insights gathered from other companies in the industry.
  1. You analyze records and reports to obtain insight into potential issues and trends.
  1. You anticipate business cycles and trends and make adjustments in a timely manner.
  1. I observe employees at work to get better insight into the issues they are dealing with.
If you were to make improvements in Strategic Insight, what are your suggestions for how you can improve this?

Fiscal Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You monitor expenses and verify the need for items purchased.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You are effective in using company's resources.
  1. You provide budgeting and accounting support to the Company.
  1. You keep excellent records for financial transparency.
If you were to make improvements in Fiscal Management, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I act immediately instead of waiting for someone else to solve the issue.
  1. You delegate tasks and assignments to subordinates as soon as a request is made.
  1. I do not procrastinate when there is a job to be done.
  1. I establish the tasks and direction for the team.
  1. You get the job done.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are open to new ideas and concepts.
  1. You share best practices with others and learn from others.
  1. You take the initiative to learn new skills.
  1. You improve on your skill sets.
  1. You grasp new ideas, concepts, technical, or business knowledge.
If you were to make improvements in Continual Learning, what are your suggestions for how you can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are able to organize work.
  1. You are effective in performing your job.
  1. You set a high standard for job performance.
  1. You produce quality
  1. You work effectively in the department.
If you were to make improvements in Performance, what are your suggestions for how you can improve this?

Goals

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You achieve goals.
  1. You conduct timely follow-up; keeps others informed on a need to know basis.
  1. You achieve established goals.
  1. You set challenging stretch goals
  1. You make sure that I have a clear idea of our group's goals.
If you were to make improvements in Goals, what are your suggestions for how you can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You avoid bottlenecks in progress by assigning multiple individuals to critical tasks.
  1. You determine which tasks are critical and which tasks are optional.
  1. You coordinate the work of a team by assigning tasks to other team members.
  1. You organize tasks for the most efficient order of completion.
  1. You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
If you were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how you can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are planful and organized.
  1. You can be counted on to add value wherever you are involved.
  1. You demonstrate the analytical skills to do your job.
  1. You take a lot of pride in your work.
  1. You produce high quality work.
If you were to make improvements in Excellence, what are your suggestions for how you can improve this?

Customer Focus

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You give feedback to the customer regularly.
  1. You attend to the customer's needs in addition to the specific needs of the project. Attended to the customer's needs in addition to the specific needs of the project.
  1. I create an environment that enables customers to receive excellent service.
  1. You ensure all customer commitments and requirements are met or exceeded.
  1. You are above average in addressing the needs of the customers.
If you were to make improvements in Customer Focus, what are your suggestions for how you can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are open to receiving feedback.
  1. You assess employees' developmental needs.
  1. You assign tasks and responsibilities to develop skills of others.
  1. You support the successes of other employees.
  1. You create opportunities for professional development.
If you were to make improvements in Developing Others, what are your suggestions for how you can improve this?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I establish good rapport with team members.
  1. I am willing to listen to the ideas of other team members.
  1. You foster an environment that promotes active listening on the team.
  1. You share pertinent information with all members of the team.
  1. I work with other team members to achieve objectives.
If you were to make improvements in Teamwork, what are your suggestions for how you 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.