HR-Survey > 360-Degree Feedback > Competency Model

Coworker Development- 360 Degree Feedback Survey Sample #5





360-Degree Assessment 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)
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



Co-worker Development

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Takes immediate action on poor performance
  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. Works to identify root causes of performance problems
  1. Sets and clearly communicates expectations, performance goals, and measurements to others


Adaptability

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is open to new ideas and innovations.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Can take on new assignments.
  1. Able to adjust to changes as needed.
  1. Adapts to new environments.


Integrity

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Protects the integrity and confidentiality of information
  1. Does what was promised.
  1. Maintains strong relationships with others.
  1. Accepts responsibility for mistakes.
  1. Fosters a high standard of ethics and integrity.


Continual Learning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Views setbacks as opportunities to learn from.
  1. Sets relevant learning objectives and goals.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Improves on their skill sets.
  1. Pursues professional development opportunities when they arise.


Punctuality

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Invoices clients on a timely basis.
  1. Maintains an efficient schedule of activities.
  1. Responds to requests for information in a timely manner.
  1. Starts meetings on time.
  1. Avoids making personal phone calls during working hours.


Supervisory Skills

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Makes decisions based on all relevant information.
  1. Meets with employees at the end of the job to debrief them.
  1. Provides clear expectations of outcomes during performance reviews.
  1. Intervenes immediately if disciplinary action is warranted.
  1. Maintains disciplinary policy and fair enforcement of work rules


Performance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Listens and responds to issues and problems
  1. Shown significant improvement in job performance.
  1. Works well in this position.
  1. Has great overall performance
  1. Sets a high standard for job performance.


Quality

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages others to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.
  1. Encourages employees to produce the best quality products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Encourages others to achieve high quality standards.


Results Oriented

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Sets priorities for tasks to be completed.
  1. Has a strong result orientation.
  1. Makes changes to the plans if it will result in increased output.
  1. Exceeds performance requirements.
  1. Works toward achievement of goals even when confronted with obstacles.


Company

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Understands the use of [Company] products and services.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Impresses upon others the important aspects of [Company].
  1. Understands how decisions impact other business units beyond their immediate department of work group.


Vision

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Develops action plans to align his/her work with the goals of the organization
  1. Communicates a vision of where the Company needs to be in the future.
  1. Behaves in a way that is consistent with business values & code of conduct



  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.