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.

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. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Determines which tasks are critical and which tasks are optional.
  1. Assigns tasks based on skills of team members.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
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. Adapts to disruptions in the supply chain to maintain production levels.
  1. Helps others when free-time is available.
  1. Measures progress toward the goal.
  1. Overcomes obstacles to continue working toward goals.
  1. Completed work exceeds standards.
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. Inspires creativity in their team.
  1. Creates a lot of new ideas.
  1. Conceives, implements and evaluates ideas.
  1. Is creative and inspirational.
  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. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Seeks opportunities for continuous learning.
  1. Keep themselves up-to-date of technical/professional issues
  1. Contributing fully to the extent of their skills
  1. Encourages employees to take courses relevant to their job.
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. Starts the workday when scheduled.
  1. Arrives to meetings on time.
  1. Avoids making personal phone calls during working hours.
  1. Responds to requests for information in a timely manner.
  1. Maintains an efficient schedule of activities.
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. Encourages others to produce the highest quality work products.
  1. Holds employees accountable for their quality of work.
  1. Corrects issues in a timely manner.
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.
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. Sets high expectations and goals; encourages others to support the organization.
  1. Achieves established goals.
  1. Makes sure that I have a clear idea of our group's goals.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Achieves 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. Makes sure employees understand why they were given certain assignments.
  1. Maintains clarity in goals and objectives.
  1. Clearly explains responsibilities to individuals.
  1. Is clear about goals that need to be achieved.
  1. Avoids creating ambiguity or mixed messages.
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. Gives others development opportunities through project assignments and increased job responsibilities
  1. Takes immediate action on poor performance
  1. Works to identify root causes of performance problems
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
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. Identifies and takes steps to prevent potential confrontations.
  1. Assists team members by helping them see the other point of view.
  1. Clearly expresses expectations to others.
  1. Discusses conflict situations with supervisor.
  1. Deals effectively with employee grievances.
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. Creates a timeline to specify when each phase of the project should be concluded.
  1. Ensures everyone in the department is onboard with the current plan.
  1. Plans for future staffing needs.
  1. Makes strategic and tactical decisions to guide the logistics process.
  1. Anticipates the impacts of strategic plans.
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.