Vision- 360 Degree Feedback Survey Sample #2





Surveys Measuring Vision:
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)
Survey 14 (4-point scale; N/A)
Instructions

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 and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Creates a vision that adds value to the organization.
  1. Develops action plans to align his/her work with the goals of the organization.
  1. Provides vision and strategies to the team.
  1. Is aware of their own actions and how that impacts the department.
  1. Charts a bold course for the department's evolution.
What are your suggestions for how [Participant Name] can make improvements
in Vision?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Listens actively & speaks clearly and directly.
  1. Keeps the supervisor informed about achievements and milestones.
  1. Delivers effective public presentations.
  1. Delivers information in a clear, concise, and logical manner.
  1. Uses polite language and shows respect for others' opinions and time.
What are your suggestions for how [Participant Name] can make improvements
in Communication Skills?

Accountability

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Develops goals and establishes objective measures of success.
  1. Does not make excuses for being late for work.
  1. Understands the importance of holding employees accountable for their work.
  1. Sets clear performance measures.
  1. Accepts personal responsibility for producing high quality and timely work.
What are your suggestions for how [Participant Name] can make improvements
in Accountability?

Continual Improvement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Looks for ways to improve work processes and procedures.
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Analyzes processes to determine areas for improvement.
  1. Promotes training and development opportunities to enhance job performance.
  1. Looks for ways to expand and learn new job skills.
What are your suggestions for how [Participant Name] can make improvements
in Continual Improvement?

Decision Making

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Uses reasonable assumptions and logic to decide between alternate courses of action
  1. Understands how different perspectives can help make better informed decisions.
  1. Applies creative reasoning in making decisions.
  1. Gathers information before making a decision.
  1. Maintains focus on the "big picture" when making decisions.
What are your suggestions for how [Participant Name] can make improvements
in Decision Making?

Objectives

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Encourages me to take on greater responsibility.
  1. Effectively organizes resources and plans
  1. Organizes and schedules events, activities, and resources.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Sets long-term and short-term goals.
What are your suggestions for how [Participant Name] can make improvements
in Objectives?

Empowering Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Listens to the ideas employees have for solving issues.
  1. Allows employees to organize their schedule to best accomplish the job.
  1. Considers ideas from employees that may challenge traditional ways of doing the job.
  1. Demonstrates confidence in the abilities of subordinates.
  1. Encourages employees to take the initiative when responding to an issue.
What are your suggestions for how [Participant Name] can make improvements
in Empowering Others?

Coaching

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Conducts regular performance appraisals and feedback.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Addresses employee behavior problems effectively.
What are your suggestions for how [Participant Name] can make improvements
in Coaching?

Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Constructively receives criticism and suggestions from others.
  1. ...treats others with respect and dignity.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Forms working relationships with employees from other departments.
What are your suggestions for how [Participant Name] can make improvements
in Others?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.