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Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Surveys Measuring Juggling 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)
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



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Juggling Multiple Responsibilities

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Prioritizes tasks for efficiency.
  1. Coordinates the work of a team by assigning tasks to other team members.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Assigns tasks based on skills of team members.
  1. Switches attention to more urgent tasks when necessary.


Empowering Others

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages employees to think outside the box.
  1. Coordinates the knowledge, skills and resources of others to accomplish more in the department.
  1. Permits employees to take training to become more independent.
  1. Enables team members to make their own decisions on the project.
  1. Allows employees to organize their schedule to best accomplish the job.


Developing Others

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages employees through recognition of positive changes in behavior.
  1. Develops employees by offering and encouraging them to take on new or additional responsibilities.
  1. Creates opportunities for professional development.
  1. Is open to receiving feedback.
  1. Assigns tasks and responsibilities to develop skills of others.


Others

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Able to see issues from others' perspectives.
  1. ...treats others with respect and dignity.
  1. Helpful
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Works across boundaries within the organization.


Strategic Focus

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Develops high-level strategic planning models to identify opportunities to improve the company.
  1. Aligns projects to the strategic goals of the company.
  1. Understands how to achieve strategic financial objectives.
  1. Pursues strategic alliances with valued partners.
  1. Communicates the company's strategic goals and decisions to teams and departments.


Fiscal Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Monitors spending.
  1. Keeps excellent records for financial transparency.
  1. Effective in using Company's resources.
  1. Develops of the department's annual budget.


Vision

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Delegates the task of implementing the vision to subordinates.
  1. Plans a roadmap for the department's growth and expansion.
  1. Develops a schedule that outlines specific phases, measurables, and deadlines, ensuring that work is systematically aligned and coordinated with the organization's vision.
  1. Defines a roadmap for realizing the organization's vision.
  1. Builds a strategic vision by analyzing the company's current position and the market environment, identifying strengths, weaknesses, opportunities, and threats.



  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.