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. Takes immediate action on poor performance
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Gives others development opportunities through project assignments and increased job responsibilities
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. Able to see issues from others' perspectives.
  1. Treats others with respect and dignity.
  1. Helpful
  1. Is 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. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
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. Understands what customs and etiquette are important for individuals from other cultures.
  1. Seeks to reduce obstacles in communication that might arise from cultural differences.
  1. Values the diverse perspectives from others.
  1. Willing to work with employees who have different cultural backgrounds.
  1. Shows respect in daily 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. Effective in performing his/her job.
  1. Works effectively in the department.
  1. Works well in this position.
  1. Listens and responds to issues and problems
  1. ...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. Actively seeks the root cause of a problem.
  1. Identifies fresh approaches and shows a willingness to question traditional assumptions.
  1. Ability to solve problems at root cause rather than at symptom level.
  1. Finds creative ways to get things done with limited resources.
  1. Is a good problem solver and decision maker
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. Determines which tasks are critical and which tasks are optional.
  1. Can multitask while performing all of their other responsibilities and activities.
  1. Is aware of the deadlines for specific tasks/assignments.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
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. Avoids stating unclear or conflicting goals.
  1. Avoids creating ambiguity or mixed messages.
  1. Communicates with clarity and efficiency.
  1. Writes clear job descriptions for positions in the organization.
  1. Seeks to reduce ambiguity in messaging and documents.
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.