Juggling Multiple Responsibilities - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

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)

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 comment section for that competency. 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.

Juggling Multiple Responsibilities

Definite Strength Meets Standards Needs Development N/A
  1. Organizes tasks for the most efficient order of completion.
  1. Can multitask while performing all of their other responsibilities and activities.
  1. Builds in extra time in the schedule for unplanned events/occurrences.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Assigns tasks based on skills of team members.


Definite Strength Meets Standards Needs Development N/A
  1. Is someone you can trust.
  1. Takes responsibility for results.
  1. Takes ownership of mistakes and learns from them.
  1. Acts like an owner when they make decisions.
  1. Defines roles, rights, and responsibilities of the team.


Definite Strength Meets Standards Needs Development N/A
  1. Follows tasks to completion.
  1. Protects the integrity and confidentiality of information
  1. Fosters an environment built upon trust.
  1. Demonstrates sincerity in actions with others.
  1. Does what was promised.

Cultural Awareness

Definite Strength Meets Standards Needs Development N/A
  1. Recognizes and values individual and cultural differences.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Treats others with dignity and respect.
  1. Shows respect in daily interactions
  1. Fosters a diverse workforce free from discrimination and harassment.

Project Management

Definite Strength Meets Standards Needs Development N/A
  1. Works with customers and clients to assess their needs and define project parameters.
  1. Anticipates potential problems and institutes controls and contingency plans to address them.
  1. Organizes, plans, and directs resources to accomplish the goals and objectives.
  1. Develops performance measures for various aspects of the project.
  1. Organizes work and sets priorities as needed.


Definite Strength Meets Standards Needs Development N/A
  1. Allows subordinates to use their own methods and procedures.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Entrusts subordinates with important tasks.
  1. Allows employees to decide how they wish to complete the tasks.

Change Management

Definite Strength Meets Standards Needs Development N/A
  1. Effective in implementing new organizational vision and values.
  1. Adopts changes to set and example for others to follow.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Assists others in understanding changes to the organization.
  1. Supports new initiatives for organizational changes to improve effectiveness.

Commitment To Result

Definite Strength Meets Standards Needs Development N/A
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Coordinates all department activities into a cohesive team effort.
  1. Maintains persistence and dedication to achieving results.
  1. Encourages commitment in others to obtain results.
  1. Committed to the team.


Definite Strength Meets Standards Needs Development N/A
  1. Develops a sustainable safety culture.
  1. Supports our company's safety programs.
  1. Participates in safety training when offered.
  1. Ensures that all supervisors are aware of regulatory and compliance measures.
  1. Performs work safely.


Definite Strength Meets Standards Needs Development N/A
  1. Maintains a state of readiness to address new and changing regulations and procedures.
  1. Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
  1. Performs audits regularly, or without notice, to ensure proper compliance with regulations.
  1. Maintains compliance with federal, state, and local laws.
  1. Interacts with auditors and regulators on a professional basis.

Empowering Others

Definite Strength Meets Standards Needs Development N/A
  1. Provides support and resources needed to accomplish goals.
  1. Distributes the workload to subordinates.
  1. Gives employees the opportunity to make their own decisions at work.
  1. Is confident in the abilities of employees assigned important tasks.
  1. Trusts employees to complete tasks assigned.


Definite Strength Meets Standards Needs Development N/A
  1. Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
  1. Identifies verbal and nonverbal cues to help interpret actions and messages.
  1. Leverages relationships with others to achieve goals.
  1. Actively listens to conversations to be able to recall important details later.
  1. Stays calm and focuses on the core issues to be discussed.


Definite Strength Meets Standards Needs Development N/A
  1. Communicates a vision of where the Company needs to be in the future.
  1. Demonstrates consistency between words and actions
  1. Leads employees in new directions.
  1. Works to support the strategy of [Company]
  1. Creates a positive vision of the future for the Company.

  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.