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Objectives - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Questionnaires Measuring Objectives:
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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Objectives

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages me to take on greater responsibility.
  1. Works toward achieving established goals and objectives.
  1. Establishes goals and objectives.
  1. Ability to establish realistic goals.
  1. Able to organize work.


Managing Performance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Awards new assignments to those who are most capable.
  1. Assigns additional responsibilities to facilitate internal employee promotions.
  1. Implements remediation plans that include specific performance goals in areas most in need of improvement.
  1. Provides additional responsibilities for employees that exceed performance standards.
  1. Ensures employees understand how work is to be completed.


Analytical

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Tests hypotheses and validates theories through empirical evidence.
  1. Creates new ways of interpreting the data.
  1. Evaluates the validity and reliability of data and research findings.
  1. Seeks new knowledge and skills to enhance analytical thinking.
  1. Is willing to revise own views when presented with new, credible information.


Problem Solving

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages team members to suggest ways to enhance efficiency, reduce waste, and prevent potential problems.
  1. Diagnoses the root causes of problems.
  1. Asks the "right" questions to size up or evaluate situations.
  1. Engages employees in the decision-making process to ensure their support before introducing a solution to a major problem.
  1. Gets buy-in from constituents before implementing solutions.


Technology Use/Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Uses technology in decision making and problem solving.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Understands and is committed to implementing new technologies.
  1. Maximizes the use of new technology to deliver products and services.


Recognition

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is sincerely interested in the suggestions of co-workers
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Recognizes team members who offer a significant contribution to a project.
  1. Lets employees know when they have done well
  1. Recognizes the abilities and skills of self and others



  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.