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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.

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
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Strategic Insight

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You strategically align projects to the goals of the company.
  1. You identify root causes of problems.
  1. You allocate proper resources for employee training to meet future needs based on insight into employee skill levels.
  1. You work with others to develop insights into the resources and actions required to produce desired results.
  1. You create values statements to ensure all employees are working under the same guiding principles.
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 keep excellent records for financial transparency.
  1. You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. You are effective in using company's resources.
  1. You monitor expenses and verify the need for items purchased.
  1. You ensure others follow the correct rules and regulations on fiscal matters.
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 take corrective action when necessary.
  1. I convert plans into actions.
  1. You make effective decisions
  1. I act quickly to create innovative products and services.
  1. You work quickly to 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 pursue self-improvement through continual learning.
  1. I view setbacks as opportunities to learn from.
  1. You seek opportunities to grow in skills and knowledge.
  1. You pursue professional development opportunities when they arise.
  1. You take the initiative to learn new skills.
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 listen and respond to issues and problems
  1. You work effectively in the department.
  1. You are able to organize work.
  1. You have great overall performance
  1. You work well in this position.
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 conduct timely follow-up; keeps others informed on a need to know basis.
  1. You achieve established goals.
  1. You make sure that I have a clear idea of our group's goals.
  1. You understand and contribute to development of strategic goals.
  1. You make sure that team members 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 rank the importance of tasks to make sure critical tasks are completed first.
  1. You prioritize tasks for efficiency.
  1. You complete multiple tasks simultaneously.
  1. You build in extra time in the schedule for unplanned events/occurrences.
  1. You can multitask while performing all of your other responsibilities and activities.
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 take a lot of pride in your work.
  1. You demonstrate the functional or technical skills necessary to do your job.
  1. You demonstrate the analytical skills to do your job.
  1. You are planful and organized.
  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. I am transparent in all communications with the customer.
  1. You make sure your interests are aligned with the customer's interests.
  1. You consistently exceed customer expectations.
  1. You deliver on commitments made to customers.
  1. I respond to feedback from 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 recognize and celebrates accomplishments of others.
  1. You try to ensure employees are ready to move to the next level.
  1. You provide constructive feedback to others.
  1. You support the successes of other employees.
  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. You carry your share of the workload
  1. You help the team decide what long term goals need to be met.
  1. You coach team members to work toward a common goal.
  1. You are able to adjust to changes in the composition of the team.
  1. You seek and listen to other's contributions
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.