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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)
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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Planning

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Purchases equipment and software that will be needed in the future.
  1. Adjusts and rearranges the schedule to maximize efficiency.
  1. Sets up and monitors timeframes and plans
  1. Prioritizes tasks based on urgency/need.


Fiscal Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Develops budgets and plans for various programs and initiatives.
  1. Monitors spending.
  1. Provides budgeting and accounting support to the Company.
  1. Effective in using Company's resources.


Recognition

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


Bias for Action

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Completes a large volume of work.
  1. Motivates others to achieve or exceed goals
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Displays high energy and enthusiasm on consistent basis.


Cultural Awareness

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is willing to include individuals with different cultural backgrounds on the team.
  1. Recognizes individual and cultural differences.
  1. Aware of their own cultural views.
  1. Acknowledges their own biases in cultural interactions.


Managing Performance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is consistent in disciplinary/corrective actions.
  1. Recognizes employees with a long and distinguished career of service.
  1. Measures job performance of subordinates against defined goals and objectives.
  1. Records production quotas on a daily basis.


Results Oriented

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Flexible and willing to change the strategy to better achieve the objectives.
  1. Is considered a high achiever.
  1. Achieves performance benchmarks.
  1. Motivated by a strong desire to exceed performance standards.


Technical

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Seeks information from others as needed.
  1. Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
  1. Knows how to produce high quality products/work.
  1. Willingly shares information and expertise; sought out as resource by others


Excellence

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Can be counted on to add value wherever they are involved.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Takes a lot of pride in their work.
  1. Demonstrates the analytical skills to do their job.


Customer Focus

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Is honest in all communication with the customers.
  1. Delivers high quality products to the customer.
  1. Maintains positive customer relationships.
  1. Is aware of expectations from 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.