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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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. Works to identify root causes of performance problems
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Provides ongoing feedback to co-workers on their development progress
  1. Takes immediate action on poor performance
  1. Gives others development opportunities through project assignments and increased job responsibilities


Adaptability

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is open to new ideas and innovations.
  1. Is aware of changes to team personnel.
  1. Learns from personal experiences and/or mistakes.
  1. Is proactive and takes steps to prepare for changes in the workplace.
  1. Is open to change and adjusts plans when needed.


Integrity

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Fosters an environment built upon trust.
  1. Accepts responsibility for mistakes.
  1. Demonstrates sincerity in actions with others.
  1. Develops trust and confidence from others.
  1. Demonstrates honesty and truthfulness at all times.


Continual Learning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is open to new ideas and concepts.
  1. Improves on their skill sets.
  1. Takes charge of their training and skills enhancement.
  1. Sets relevant learning objectives and goals.
  1. Seeks opportunities to grow in skills and knowledge.


Punctuality

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Starts the workday when scheduled.
  1. Arrives to meetings on time.
  1. Maintains an efficient schedule of activities.
  1. Conducts appointments at scheduled start time.
  1. Avoids making personal phone calls during working hours.


Supervisory Skills

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Empowers employees to make their own decisions in the field.
  1. Enhances teamwork through good supervision.
  1. Knows the best ways to communicate effectively with different types of employees.
  1. Meets with employees at the end of the job to debrief them.
  1. Implements disciplinary policy in accordance with the union contract


Performance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Has great overall performance
  1. Able to organize work.
  1. Listens and responds to issues and problems
  1. ...Overall Performance
  1. Effectively organizes resources and plans


Quality

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is flexible in addressing issues related to quality.
  1. Creates a culture of quality standards in the workplace.
  1. Communicates quality standards clearly.
  1. Ensures the hiring of employees that have a quality focus.
  1. Regularly measures product specifications to ensure uniformity and quality control.


Results Oriented

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Works hard despite obstacles that impede progress.
  1. Directs team in prioritizing daily work activities
  1. Determines the best approach to achieving the expected results.
  1. Flexible and willing to change the strategy to better achieve the objectives.
  1. Sets a common goals for the team.


Company

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Attends [Company] gatherings and social events.
  1. Follows existing procedures and processes.
  1. Understands the use of [Company] products and services.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Impresses upon others the important aspects of [Company].


Vision

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Turns the department's vision into defined objectives and a strategic framework.
  1. Converts the department's vision into specific goals and a strategic plan.
  1. Shapes strategies that resonate with the department's shared vision.
  1. Communicates a vision of where the Company needs to be in the future.
  1. Provides the vision needed to help the organization remain competitive and adaptable in a dynamic market.



  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.