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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)
Survey 13 (4-point scale; numbers; floating anchors)
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:
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
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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. Provides ongoing feedback to co-workers on their development progress
  1. Works to identify root causes of performance problems
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
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. Works across boundaries within the organization.
  1. Works effectively with people from other departments.
  1. ...treats others with respect and dignity.
  1. Includes others in the decision making processes.
  1. Able to see issues from others' perspectives.
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. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Uses patience and self-control in working with customers and associates.
  1. Steps away from a situation to process appropriate response.
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. Is aware of differences in how individuals from other cultures greet one another.
  1. Understands what customs and etiquette are important for individuals from other cultures.
  1. Acknowledges their own biases in cultural interactions.
  1. Welcomes diverse cultural input when shaping organizational strategy or policy.
  1. Values the opinions of diverse groups and individual.
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. Works well in this position.
  1. Able to organize work.
  1. Works effectively in the department.
  1. Effectively organizes resources and plans
  1. Has great overall performance
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. Evaluates alternative courses of action.
  1. Is smooth and seamless in transitions between different ideas and approaches, avoiding getting stuck in one line of thinking.
  1. Uses creative thinking to develop new solutions to problems.
  1. Asks the right questions to size up or evaluate situations.
  1. Values the diversity of thought that can uncover unique angles and approaches that might not emerge in a more homogeneous group.
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. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Switches attention to more urgent tasks when necessary.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Can multitask while performing all of their other responsibilities and activities.
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. Is clear about the roles and duties of team members.
  1. Clearly explains the vision and goals of the company.
  1. Uses appropriate grammar and tense in communications.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Avoids creating ambiguity or mixed messages.
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.