Trustworthy - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Trustworthiness:
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:
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


Trustworthy

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Delivers on promises made.
  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. Takes ownership, delivers on commitments
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. Examines for patterns in data to help predict future possibilities.
  1. Understands how different perspectives can help make better informed decisions.
  1. Supports, encourages or helps others to be sure about the decisions they are making.
  1. Exercises good judgment by making sound and informed decisions.
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. Prepares equipment at the start of the shift.
  1. Takes corrective action when necessary.
  1. Is not afraid to take corrective action when necessary.
  1. Creates opportunities and then takes advantage of them.
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. Is open to receiving feedback.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Supports the successes of other employees.
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. Promotes training and development opportunities to enhance job performance.
  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. Looks for ways to expand and learn new job skills.
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. Is easy to approach with ideas and opinions.
  1. Looks to others for input.
  1. Considers other's opinion and suggestions.
  1. Asks others for their ideas and opinions.
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. Contributes to a positive and fun work environment.
  1. Treats all people fairly and with respect.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
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. Works effectively in the department.
  1. Listens and responds to issues and problems
  1. Shown significant improvement in job performance.
  1. Has great overall 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. Finds creative ways to get things done with limited resources.
  1. Generates alternative solutions to problems and challenges.
  1. Implements effective solutions to critical problems.
  1. Actively seeks the root cause of a problem.
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. Completes work to given time frame and to budget
  1. Met required benchmarks for the position.
  1. Set high standards in their performance
  1. Highly motivated to achieve or exceed performance standards.
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. Is aware of federal and local laws affecting employees.
  1. Familiar with EEOC, FLSA, OSHA and ERISA acts/standards.
  1. Provides documents and reports as needed to maintain compliance with laws.
  1. Is aware of the documents and reports needed to maintain compliance with regulations.
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. Describes and summarizes data.
  1. Able to correctly assess current/estimated valuations.
  1. Understands the dynamics of our industry.
  1. Seeks to better understand other areas of the company, including their operations, personnel, and output.
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.