Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #2





Surveys measuring the ability to handle multiple responsibilities:
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

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 and the goals they were asked to achieve. 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 discussed with the employee to foster growth and on-going development.

Competencies Included:
Juggling Multiple Responsibilities, Results Oriented, Creativity, Professional Development, Punctuality, Quality, Goals, Clarity, Co-worker Development, Conflict Management, Planning
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 between . The survey will only be available during these dates.


Juggling Multiple Responsibilities

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Ranks the importance of tasks to make sure critical tasks are completed first.
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Builds in extra time in the schedule for unplanned events/occurrences.
What are your suggestions for how [Participant Name] can make improvements
in Juggling Multiple Responsibilities?

Results Oriented

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Creates measures of performance to track progress.
  1. Makes sure employees have the resources they need to achieve their results.
  1. Strives to exceed performance benchmarks.
  1. Encourages employees to give 100% to achieving high results.
  1. Determines the proper order for completion of the tasks.
What are your suggestions for how [Participant Name] can make improvements
in Results Oriented?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Develops solutions to challenging problems.
  1. Is creative and inspirational.
  1. Inspires creativity in their team.
  1. Conceives, implements and evaluates ideas.
  1. Adds value to the department/organization.
What are your suggestions for how [Participant Name] can make improvements
in Creativity?

Professional Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Contributing fully to the extent of their skills
  1. Allows employees to fully participate in employee training and professional development.
  1. Seeks opportunities for professional development.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Seeks opportunities for continuous learning.
What are your suggestions for how [Participant Name] can make improvements
in Professional Development?

Punctuality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Maintains an efficient schedule of activities.
  1. Conducts appointments at scheduled start time.
  1. Starts meetings on time.
  1. Invoices clients on a timely basis.
  1. Starts the workday when scheduled.
What are your suggestions for how [Participant Name] can make improvements
in Punctuality?

Quality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ensures the hiring of employees that have a quality focus.
  1. Adopts and implements best practices when it comes to quality procedures.
  1. Able to create quality initiatives to be implemented organization-wide.
  1. Analyzes quality improvement plans and initiatives.
  1. Able to identify quality issues critical to the organization.
What are your suggestions for how [Participant Name] can make improvements
in Quality?

Goals

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Achieves goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Establishes and documents goals and objectives.
  1. Achieves established goals.
What are your suggestions for how [Participant Name] can make improvements
in Goals?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is clear about the roles and duties of team members.
  1. Maintains clarity in goals and objectives.
  1. Communicates with clarity and efficiency.
  1. Is clear about goals that need to be achieved.
  1. Clearly explains responsibilities to individuals.
What are your suggestions for how [Participant Name] can make improvements
in Clarity?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Works to identify root causes of performance problems
  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. Adapts coaching and mentoring approach to meet the style or needs of individuals
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is supportive of consensus and power sharing.
  1. Addresses concerns about the availability of limited resources.
  1. Shares competing viewpoints to expand viewpoints.
  1. Strives to ensure that all basic needs are met, resulting in mutual benefits for both parties.
  1. Attentively hears each person as they share their distinct viewpoints on the matter.
What are your suggestions for how [Participant Name] can make improvements
in Conflict Management?

Planning

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Assesses the risks of various strategic plans.
  1. Is able to clearly articulate the plan for the department/district.
  1. Open to input from others into the plan for development of the strategic plan.
  1. Sets the appropriate sequence of tasks to efficiently achieve the goal.
  1. Able to identify the needs of the department before a major change.
What are your suggestions for how [Participant Name] can make improvements
in Planning?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.