HR-Survey > 360-Degree Feedback > Competency Model

Feedback - 360 Degree Feedback Survey Sample #6





360-Degree Assessment Survey

Questionnaires Measuring Feedback:
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:

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.

Sample Result Document in PDF format:
360-Feedback Results (pdf)
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

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



Feedback

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Looks to others for input.
  1. Open to the suggestions of others.
  1. Is easy to approach with ideas and opinions.
  1. Accepts the views of others.
  1. Asks others for their ideas and opinions.


Attitude

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Contributes to a positive and fun work environment.
  1. Visibly supports and encourages diversity in style and background.
  1. Treats all people fairly and with respect.
  1. Is gracious and professional in their interactions with others.


Quality

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Encourages others to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.
  1. Encourages others to achieve high quality standards.
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.


Achievement

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Sets challenging goals for the department.
  1. Created impactful reports for the re-organization committee.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.


Safety

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Develops safety guidelines for the department.
  1. Commits adequate resources toward safety measures.
  1. Identifies and addresses safety needs.
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Develops a sustainable safety culture.


Conflict Management

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Discusses conflict situations with supervisor.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Clearly expresses expectations to others.
  1. Tries to understand others' point of view before making judgments


Strategic Focus

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Reinforces the strategic messaging in various teams, meetings, seminars and workshops.
  1. Communicates the company's strategic goals and decisions to teams and departments.
  1. Identifies and addresses strategic risks impacting operations.
  1. Develops strategies that are practical and can be feasibly implemented within a reasonable period of time.
  1. Maintains a strategic focus to sustain competitiveness in changing business environments.


Entrepreneurship

Needs
Significant
Improvement
Could benefit
from
Development
Capable
and
Effective
Role
Model
  1. Is comfortable operating in an environment of uncertainty.
  1. Understands the processes and various stages of business development.
  1. Takes the initiative to complete tasks.
  1. Exhibits determination and passion in completion of goals.
  1. Maintains a high level of energy to respond to demands of the job.



  1. Overall, please rate the effectiveness of [Participant Name Here].






  2. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.


  3. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.


  4. Additional comments, if any for [Participant Name Here]'s assessment.