Action - 360 Degree Feedback Survey Sample #11





360 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)
Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Competencies Included:
Action, Self Management, Performance, Time Management, Developing Others, Organizational Fluency
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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


Action

What does Action mean?
It means that ...
  • I take steps to prepare for the start of the project.
  • You get the job done.
  • You anticipate critical incidents in the department and take steps to mitigate their effect.
  • I conduct critical-incident reviews immediately after the event.
  • You prepare equipment at the start of the shift.

To what extent does this person exhibit Action?
Select from one of the ratings below.

Self Management

What does Self Management mean?
It means that ...
  • You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  • You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  • You analyze interpersonal problems instead of reacting to them.
  • You consciously control own negative emotions in order to keep team morale up.
  • You step away from a situation to process appropriate response.

To what extent does this person exhibit Self Management?
Select from one of the ratings below.

Performance

What does Performance mean?
It means that ...
  • You work well in this position.
  • You have great overall performance
  • You effectively organize resources and plans
  • You shown significant improvement in job performance.
  • You set a high standard for job performance.

To what extent does this person exhibit Performance?
Select from one of the ratings below.

Time Management

What does Time Management mean?
It means that ...
  • I ensure timely completion of vital work.
  • I emphasize punctuality in the department and make sure employees know they are expected to be on time.
  • You deal effectively with interruptions.
  • You complete tasks ahead of schedule.
  • You make time for developing plans and schedules.

To what extent does this person exhibit Time Management?
Select from one of the ratings below.

Developing Others

What does Developing Others mean?
It means that ...
  • You create opportunities for professional development.
  • You provide constructive feedback to others.
  • You develop employees by offering and encouraging them to take on new or additional responsibilities.
  • You assess employees' developmental needs.
  • You set performance objectives for subordinates that encourages development opportunities.

To what extent does this person exhibit Developing Others?
Select from one of the ratings below.

Organizational Fluency

What does Organizational Fluency mean?
It means that ...
  • You understand departmental policies and procedures.
  • You are able to explain departmental policies and procedures to others.
  • You are effective in communicating with others within the organization.
  • You are aware of other organizational cultures to compare/contrast with the current organizational culture.
  • You get things done through the department.

To what extent does this person exhibit Organizational Fluency?
Select from one of the ratings below.
Strengths


Areas for Development


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