hr-survey.com

Action - 360 Degree Feedback Survey Sample #2





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)
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.


Action

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Makes effective decisions, even when under pressure.
  1. Does whatever it takes (within reason) to get the job done.
  1. Motivates & supports others to gain skills
  1. Works quickly when faced with difficult problems.
  1. Displays high energy and enthusiasm on consistent basis.
What are your suggestions for how [Participant Name] can make improvements
in Action?

Punctuality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Starts the workday when scheduled.
  1. Starts meetings on time.
  1. Conducts appointments at scheduled start time.
  1. Responds to requests for information in a timely manner.
  1. Avoids making personal phone calls during working hours.
What are your suggestions for how [Participant Name] can make improvements
in Punctuality?

Attitude

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Builds open and trusting relationships.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Contributes to a positive and fun work environment.
  1. Contributes to a positive work environment.
What are your suggestions for how [Participant Name] can make improvements
in Attitude?

Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is ready to offer help
  1. Sets an example for others to follow
  1. Keep staff informed about what is happening in the company
  1. Makes you feel enthusiastic about your work
  1. Delegate tasks effectively
What are your suggestions for how [Participant Name] can make improvements
in Management?

Commitment To Result

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Takes immediate action toward goals.
  1. Able to focus on a task even when working alone.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
What are your suggestions for how [Participant Name] can make improvements
in Commitment To Result?

Technical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Willingly shares information and expertise; sought out as resource by others
  1. Willingly shares his/her technical expertise; sought out as resource by others
  1. Demonstrates mastery of the technical competencies required in his/her work.
What are your suggestions for how [Participant Name] can make improvements
in Technical?

Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes ownership, delivers on commitments
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Delivers on promises made.
  1. Is trustworthy; is someone I can trust.
  1. Is a person you can trust.
What are your suggestions for how [Participant Name] can make improvements
in Trustworthy?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Identifies and takes steps to prevent potential confrontations.
  1. Tries to understand others' point of view before making judgments
  1. Clearly expresses expectations to others.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Deals effectively with employee grievances.
What are your suggestions for how [Participant Name] can make improvements
in Conflict Management?

Teamwork

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Provides assistance and support to other team members when needed
  1. Encourages open communication
  1. Seeks and listens to other's contributions
  1. Builds consensus and shares relevant information.
  1. Demonstrates compassion and respect for others through actions; is concerned about their work and non-work issues
What are your suggestions for how [Participant Name] can make improvements
in Teamwork?

Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Creates a positive vision of the future for the Company.
  1. Develops action plans to align his/her work with the goals of the organization
  1. Works to support the strategy of [Company]
  1. Communicates a vision of where the Company needs to be in the future.
What are your suggestions for how [Participant Name] can make improvements
in Vision?


  1. Strengths


  2. Areas for Development


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