HR-Survey > 360-Degree Feedback > Competency Model

Clarity - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Questionnaires Measuring Clarity:
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)
Dear Employee:

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 Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing 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 by .

Thank you for your participation in the survey.

Management Team



Clarity

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Attends to the important details of a job or task.
  1. Writes clear job descriptions for positions in the organization.
  1. Makes sure employees understand why they were given certain assignments.
  1. Uses appropriate grammar and tense in communications.


Administrative Skill

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Able to develop, justify and present a budget.
  1. Completes reports on-time.
  1. Takes responsibility for decisions.
  1. High attention to detail.


Time Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Determines which tasks need to be completed urgently.
  1. Organizes work responsibilities for maximum efficiency.
  1. Continues working on the most important tasks until they are completed.
  1. Is committed to finishing the most important tasks.


Results Oriented

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages employees to give 100% to achieving high results.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Completes work on time.
  1. Directs team in prioritizing daily work activities


Technology Use/Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Maximizes the use of new technology to deliver products and services.
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.


Excellence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Keeps themselves and others focused on constant improvement.
  1. Can be counted on to add value wherever they are involved.
  1. Demonstrates the analytical skills to do their job.
  1. Demonstrates the functional or technical skills necessary to do their job.


Safety

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Develops a strong safety culture.
  1. Points out behaviors in others that may be unsafe.
  1. Performs work safely.
  1. Commits adequate resources toward safety measures.


Trustworthy

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Takes ownership, delivers on commitments
  1. Is trustworthy; is someone I can trust.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Demonstrates congruence between statements and actions.


Responsible

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Holds herself / himself accountable to goals / objectives
  1. Behavior is ethical and honest.
  1. Sets a good example
  1. Acts as a resource without removing individual responsibility.


Developing Others

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Is open to receiving feedback.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Creates opportunities for professional development.


Planning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Develops plans to ensure the smooth operation of the supply chain.
  1. Creates to-do lists to make sure nothing is missed.
  1. Assesses the risks of various strategic plans.
  1. Prioritizes tasks based on urgency/need.



  1. Overall, please rate the effectiveness of [Participant Name Here].






  2. Strengths


  3. Areas for Development


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