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)
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.

Competencies Included:
Strategic Insight, Fiscal Management, Action, Continual Learning, Performance, Goals, Juggling Multiple Responsibilities, Excellence, Customer Focus, Developing Others, Teamwork
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. You strategically align projects to the goals of the company.
  1. I pursue strategic alliances with valued partners.
  1. You create strategies that significantly benefit the Company.
  1. You implement long-term solutions to problems.
  1. You anticipate business cycles and trends and makes adjustments in a timely manner.
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 provide budgeting and accounting support to the Company.
  1. You monitor expenses and verify the need for items purchased.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You monitor spending.
  1. You develop of the department's annual budget.
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. You set high standards for yourself and others.
  1. You work across organizational lines and boundaries to attain goals.
  1. I take steps to prepare for the start of the project.
  1. I convert plans into actions.
  1. You undertake actions to achieve specific goals.
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 improve on your skill sets.
  1. You take the initiative to learn new skills.
  1. You build on your strengths while addressing your weaknesses.
  1. You participate in regular training offered.
  1. You pursue self-improvement through continual learning.
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 work well in this position.
  1. You set a high standard for job performance.
  1. You work effectively in the department.
  1. You listen and respond to issues and problems
  1. You effectively organize resources and plans
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 make sure that I have a clear idea of our group's goals.
  1. You conduct timely follow-up; keeps others informed on a need to know basis.
  1. You make sure that team members have a clear idea of our group's goals.
  1. You understand and contribute to development of strategic goals.
  1. You achieve 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 manage impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. You determine which tasks are critical and which tasks are optional.
  1. You integrate developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. You use a scheduler/planner to keep tasks organized and on time.
  1. You build in extra time in the schedule for unplanned events/occurrences.
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 produce high quality work.
  1. You demonstrate the analytical skills to do your job.
  1. You demonstrate the functional or technical skills necessary to do your job.
  1. You take a lot of pride in your work.
  1. You can be counted on to add value wherever you are involved.
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 are aware of what the customer wants to receive.
  1. You prioritize the needs and preferences of the customer.
  1. You create customized solutions for the customer.
  1. You understand the needs of the customer.
  1. You do not hesitate to address customer concerns or complaints.
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 set performance objectives for subordinates that encourages development opportunities.
  1. You recognize and celebrates accomplishments of others.
  1. You try to ensure employees are ready to move to the next level.
  1. You assess employees' developmental needs.
  1. You encourage employees through recognition of positive changes in behavior.
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 work with other team members to identify bottle necks in the production process.
  1. You take the time to actively listen to other team member's perspectives.
  1. I encourage other team members to adopt new procedures.
  1. You appreciate the input from other team members.
  1. You are open to new ideas that may change own goals for benefit of the team
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.