HR-Survey > 360-Degree Feedback > Competency Model > Action

Action - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Action:
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:

[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:
Action, Continual Learning, Leadership, Delegation, Adaptability, Juggling Multiple Responsibilities, Interpersonal Skills, Co-worker Development, Others, Entrepreneurship
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


Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Anticipates needs and takes pre-emptive action to address the issue.
  1. Approves purchase requests in a timely manner.
  1. Works across organizational lines and boundaries to attain goals.
  1. Effectively handles multiple complex issues simultaneously.
  1. Takes the initiative to address problems sooner rather than later.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Improves on their skill sets.
  1. Shares best practices with others and learns from others.
  1. Is open to new ideas and concepts.
  1. Views setbacks as opportunities to learn from.
  1. Grasps new ideas, concepts, technical, or business knowledge.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Leads team to set goals, solve problems, and accomplish tasks.
  1. Is a highly effective supervisor.
  1. Able to align manpower, design work, an allocate tasks to achieve goals.
  1. Holds others accountable for their actions.
  1. Sets a high level of performance expectations and challenges others to do the same.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Delegation

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Clearly defines duties and tasks to be completed.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Entrusts subordinates with important tasks.
If [Participant Name] were to make improvements in Delegation, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to work effectively with new people and new teams.
  1. Works effectively with various personalities of team members.
  1. Adapts to diversity within the team.
  1. Adjusts priorities to changing business goals.
  1. Able to step in and help co-workers when needed.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Can multitask while performing all of their other responsibilities and activities.
  1. Is aware of the deadlines for specific tasks/assignments.
  1. Organizes tasks for the most efficient order of completion.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Interpersonal Skills

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Anticipates the concerns of other employees.
  1. Uses tact, compassion, and sensitivity in interactions with others.
  1. Adapts management style to meet the needs of the individual or situation.
  1. Easily approachable.
  1. Willing to overlook personal differences and focus on completing the task at hand.
If [Participant Name] were to make improvements in Interpersonal Skills, what are your suggestions for how he/she can improve this?

Co-worker Development

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Takes immediate action on poor performance
  1. Provides ongoing feedback to co-workers on their development progress
  1. Works to identify root causes of performance problems
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can improve this?

Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Consistently demonstrates ability and willingness to trust others.
  1. Works effectively with people from other departments.
  1. Respects the opinions of other employees.
  1. Helpful
  1. Forms working relationships with employees from other departments.
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Entrepreneurship

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Encourages risk taking for developing potential business opportunities.
  1. Balances risks and rewards when making decisions.
  1. Maintains a high level of energy to respond to demands of the job.
  1. Has a strategic awareness on how to promote the organization.
  1. Is comfortable operating in an environment of uncertainty.
If [Participant Name] were to make improvements in Entrepreneurship, 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.