HR-Survey > 360-Degree Feedback > Competency Model

Planning- 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Surveys Measuring Planning:
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)
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



Planning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Understands what equipment will be needed for the project.
  1. Prioritizes tasks based on urgency/need.
  1. Sets the appropriate sequence of tasks to efficiently achieve the goal.
  1. Accurately estimates the amount of materials/supplies needed for the project.


Fiscal Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Ensures others follow the correct rules and regulations on fiscal matters.
  1. Monitors spending.
  1. Monitors expenses and verifies the need for items purchased.
  1. Develops of the department's annual budget.


Recognition

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


Bias for Action

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Encourages risk taking and experimentation to improve performance
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Completes a large volume of work.
  1. Displays high energy and enthusiasm on consistent basis.


Cultural Awareness

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Seeks opportunities to learn about the other cultural backgrounds of colleagues.
  1. Is responsive to individuals from other cultures.
  1. Is aware of the similarities and differences among and between cultural groups.


Managing Performance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Holds the team accountable for meeting objectives.
  1. Provides employees with training as needed to increase their performance.
  1. Aligns individual and team goals with the organization's goals and objectives.
  1. Sets clear and ambitious goals to be met.


Results Oriented

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Sets priorities for tasks to be completed.
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Determines the objectives for the project.
  1. Sets challenging goals to be achieved.


Technical

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Demonstrates mastery of the technical competencies required in his/her work.
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Willingly shares his/her technical expertise; sought out as resource by others
  1. Knows how to produce high quality products/work.


Excellence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Takes a lot of pride in their work.
  1. Is planful and organized.
  1. Produces high quality work.
  1. Keeps themselves and others focused on constant improvement.


Customer Focus

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Provides training to others on how to improve customer service.
  1. Consistently models positive customer service attitudes.
  1. Is committed to resolving customer issues in a positive way.
  1. Is competent in handling difficult customers.



  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.