Others- 360 Degree Feedback Survey Sample #2





Surveys Measuring Others:
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.

Competencies Included:
Others, Adaptability, Self Management, Establishing Focus/Direction, Analytical, Problem Solving, Technology Use/Management, Business Acumen, Company
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.


Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Supports the efforts of other employees in implementing solutions to problems.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Constructively receives criticism and suggestions from others.
  1. Is able to see issues from others' perspectives.
  1. Forms working relationships with employees from other departments.
  1. Helpful
What are your suggestions for how [Participant Name] can make improvements
in Others?

Adaptability

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Adjusts plans to meet new situations.
  1. Adjusts priorities to the new Corporate mission.
  1. Responsive to the needs of others.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Adjusts tactics when things are not working as expected.
  1. Adjusts plans to meet the needs of new constraints.
What are your suggestions for how [Participant Name] can make improvements
in Adaptability?

Self Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
What are your suggestions for how [Participant Name] can make improvements
in Self Management?

Establishing Focus/Direction

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Excellent at managing time.
  1. Stays focused even when under pressure and stress.
  1. Makes sure that employees understand how their work relates to organizational goals.
  1. Aligns the department's goals with the goals of the organization.
  1. Helps guide employees with prioritizing tasks.
  1. Makes sure that employees understand and identify with the team's mission.
What are your suggestions for how [Participant Name] can make improvements
in Establishing Focus/Direction?

Analytical

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Implements data validation techniques and methods.
  1. Identifies opportunities for progress and innovation.
  1. Prioritizes various actions to be taken when solving a problem.
  1. Identifies problems and issues needing resolution.
  1. Uses appropriate techniques to solve problems.
  1. Examines problems in depth and from multiple points of view.
What are your suggestions for how [Participant Name] can make improvements
in Analytical?

Problem Solving

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ability to develop innovative solutions to problems.
  1. Solves problems that have difficult or conflicting constraints.
  1. Skilled at quickly diagnosing issues, identifying root causes, and developing and implementing effective solutions in the workplace.
  1. Generates alternative solutions to problems and challenges.
  1. Actively seeks the root cause of a problem.
  1. Understands the root causes of problems.
What are your suggestions for how [Participant Name] can make improvements
in Problem Solving?

Technology Use/Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Understands and is committed to implementing new technologies.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Uses technology in decision making and problem solving.
  1. Maximizes the use of new technology to deliver products and services.
  1. Proficient in the use of technical systems and processes.
What are your suggestions for how [Participant Name] can make improvements
in Technology Use/Management?

Business Acumen

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Establishes key performance indicators (KPIs) to measure progress and success.
  1. Incorporates innovative approaches and being adaptable to change.
  1. Is up-to-date with regulatory guidelines and policies.
  1. Identifies new business opportunities.
  1. Calculates return on investment (ROI) for various business projects.
  1. Understands complex issues and problems.
What are your suggestions for how [Participant Name] can make improvements
in Business Acumen?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Maintains positive relationships between the [Company] and the community.
  1. Attends [Company] gatherings and social events.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Effectively represents the department in company gatherings.
What are your suggestions for how [Participant Name] can make improvements
in Company?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.