Coworker Development- 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Coworker Development:
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:

[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:
Co-worker Development, Others, Self Management, Cultural Awareness, Performance, Problem Solving, Juggling Multiple Responsibilities, Clarity
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


Co-worker Development

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Takes immediate action on poor performance
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. Forms working relationships with employees from other departments.
  1. ...treats others with respect and dignity.
  1. Treats others with respect and dignity.
  1. Able to see issues from others' perspectives.
  1. Helpful
If [Participant Name] were to make improvements in Others, what are your suggestions for how he/she can improve this?

Self Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Uses patience and self-control in working with customers and associates.
  1. Steps away from a situation to process appropriate response.
  1. Consciously controls own negative emotions in order to keep team morale up.
If [Participant Name] were to make improvements in Self Management, what are your suggestions for how he/she can improve this?

Cultural Awareness

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Fosters a diverse workforce free from discrimination and harassment.
  1. Willing to work with employees who have different cultural backgrounds.
  1. Participates in cultural training sessions/classes.
  1. Hires individuals with different cultural backgrounds for the department.
  1. Acknowledges their own biases in cultural interactions.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to organize work.
  1. Listens and responds to issues and problems
  1. Effective in performing his/her job.
  1. Effectively organizes resources and plans
  1. Works well in this position.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Problem Solving

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Skilled at quickly diagnosing issues, identifying root causes, and developing and implementing effective solutions in the workplace.
  1. Ability to solve problems at root cause rather than at symptom level.
  1. Works cooperatively with others to solve problems.
  1. Identifies and assesses all potential responses to a problem.
  1. Able to balance the needs of different people in a solution to a problem.
If [Participant Name] were to make improvements in Problem Solving, 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. Begins tasks as soon as possible.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Is aware of the deadlines for specific tasks/assignments.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Clarity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Makes sure employees understand why they were given certain assignments.
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Clearly explains responsibilities to individuals.
  1. Communicates with clarity and efficiency.
  1. Is clear about goals that need to be achieved.
If [Participant Name] were to make improvements in Clarity, 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.