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.

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. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Bounces back from daily crisis, disappointments and frustrations.
  1. Assesses current capabilities before committing to new requests from customers.
  1. Can multi-task while performing all of their other responsibilities and activities.


Definite Strength Meets Standards Needs Development N/A
  1. Accepts accountability for their actions and results.
  1. Is someone you can trust.
  1. Creates a consistent process for prioritizing work.
  1. Can be counted on to do what they say they are going to do.
  1. Defines roles, rights, and responsibilities of the team.


Definite Strength Meets Standards Needs Development N/A
  1. Follows tasks to completion.
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Demonstrates sincerity in actions with others.
  1. Does what was promised.
  1. Fosters a high standard of ethics and integrity.

Cultural Awareness

Definite Strength Meets Standards Needs Development N/A
  1. Treats others with dignity and respect.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Fosters a diverse workforce free from discrimination and harassment.

Project Management

Definite Strength Meets Standards Needs Development N/A
  1. Develops performance measures for various aspects of the project.
  1. Anticipates potential problems and institutes controls and contingency plans to address them.
  1. Inspires others to accomplish goals and objectives.
  1. Organizes work and sets priorities as needed.
  1. Organizes, plans, and directs resources to accomplish the goals and objectives.


Definite Strength Meets Standards Needs Development N/A
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Defines goals and objectives for subordinates.
  1. Tells subordinates what to do, not how to do it.
  1. Entrusts subordinates with important tasks.

Change Management

Definite Strength Meets Standards Needs Development N/A
  1. Effective in dealing with ambiguous and challenging situations.
  1. Effective in implementing new organizational vision and values.
  1. Adopts changes to set and example for others to follow.
  1. Works cooperatively with others to implement changes.
  1. Addresses organizational and departmental resistance to changes.

Commitment To Result

Definite Strength Meets Standards Needs Development N/A
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Coordinates all department activities into a cohesive team effort.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Able to focus on a task even when working alone.


Definite Strength Meets Standards Needs Development N/A
  1. Committed to safety in the workplace.
  1. Participates in safety training as applicable.
  1. Supports our company's safety programs.
  1. Encourages others to work safely.
  1. Supports safety programs and procedures.


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. Ensures regulations are followed as required.
  1. Understands and adheres to internal and external regulations.
  1. Keeps informed of various regulations and procedures.

Empowering Others

Definite Strength Meets Standards Needs Development N/A
  1. Distributes the workload to subordinates.
  1. Sets clear goals for others to accomplish.
  1. Encourages employees to solve problems on their own.
  1. Avoids micromanaging their employees.
  1. Allows individuals to be responsible for their decisions.


Definite Strength Meets Standards Needs Development N/A
  1. Able to control their emotional responses and correctly gauge the emotions of others.
  1. Stays calm and focuses on the core issues to be discussed.
  1. Able to clearly express thoughts and concerns.
  1. Researches the needs of the other party to identify strengths and weaknesses of positions.
  1. Understands the expectations of other parties in the negotiation.


Definite Strength Meets Standards Needs Development N/A
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Develops action plans to align his/her work with the goals of the organization
  1. Works to support the strategy of [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.