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Trustworthy - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Trustworthy:
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:

[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:
Trustworthy, Decision Making, Action, Developing Others, Continual Improvement, Feedback, Attitude, Performance, Problem Solving, Achievement, Regulatory/Compliance, Business Acumen
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
Edit this Survey
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Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is trustworthy; is someone I can trust.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?

Decision Making

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Decides which long-term goals should be met.
  1. Supports, encourages or helps others to be sure about the decisions they are making.
  1. Understands how different perspectives can help make better informed decisions.
  1. Is open to listening to others who may have different ideas.
If [Participant Name] were to make improvements in Decision Making, what are your suggestions for how he/she can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Looks for extra ways to help the department achieve performance goals.
  1. Drives and mobilizes others progress toward goals.
  1. Takes responsibility for actions.
  1. Is the first to volunteer for assignments.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Developing Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Supports the successes of other employees.
  1. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Recognizes and celebrates accomplishments of others.
  1. Provides constructive feedback to others.
If [Participant Name] were to make improvements in Developing Others, what are your suggestions for how he/she can improve this?

Continual Improvement

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

Feedback

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Looks to others for input.
  1. Accepts the views of others.
  1. Asks others for their ideas and opinions.
  1. Seeks feedback to enhance performance.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?

Attitude

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Contributes to a positive work environment.
  1. Visibly supports and encourages diversity in style and background.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Treats all people fairly and with respect.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to organize work.
  1. Shown significant improvement in job performance.
  1. Effective in performing his/her job.
  1. Sets a high standard for job performance.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Problem Solving

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Identifies potential courses of action.
  1. Plans the order of actions, considering any interdependent steps.
  1. Anticipates potential problems dealing with them in advance.
  1. Implements the ongoing tracking of key metrics and indicators to ensure the solution continues to perform as expected.
If [Participant Name] were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Completed training on the new equipment.
  1. Completes work to given time frame and to budget
  1. Reduces staff turnover.
  1. Demonstrates a well-organized and timely approach to achieve desired results
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Regulatory/Compliance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Creates documents and reports as needed to maintain compliance with regulations.
  1. Prepares and presents annual reports as required.
  1. Responds promptly to inquiries from regulatory bodies.
  1. Periodically assesses the effectiveness of regulatory/compliance programs.
If [Participant Name] were to make improvements in Regulatory/Compliance, what are your suggestions for how he/she can improve this?

Business Acumen

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Periodically assesses the current market environment.
  1. Seeks to better understand other areas of the company, including their operations, personnel, and output.
  1. Thoroughly understands the business needs of the customer.
  1. Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
If [Participant Name] were to make improvements in Business Acumen, 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.