hr-survey.com
HR-Survey > 360-Degree Feedback > Competency Model > Responsibility

Responsibility - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Responsibility:
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)
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:
Responsible, Emotional Intelligence, Management, Supervisory Skills, Professional Development, Persuasion and Influence, Objectives, Client Focus, Co-worker Development, Entrepreneurship, 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.
Edit this Survey
Would you like to edit this survey? Click here to begin.


Responsible

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Completes assigned work tasks.
  1. Acts as a resource without removing individual responsibility.
  1. Works in a way that makes others want to work with her/him.
  1. Is a person you can trust.
  1. Responsible for setting the vision of the department.
What are your suggestions for how [Participant Name] can make improvements
in Responsible?

Emotional Intelligence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Accurately perceives the emotional reactions of others.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Able to understand others' points of view.
  1. Is able to manage their own emotions.
  1. Is able to control their own emotions.
What are your suggestions for how [Participant Name] can make improvements
in Emotional Intelligence?

Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Maintains composure and professionalism when addressing performance issues or workplace tension.
  1. Leverages conflict situations to strengthen team relationships, clarify expectations, or improve processes.
  1. Assesses team performance against defined standards.
  1. Treats others with respect and fairness, modeling inclusive and professional behavior across roles.
  1. Anticipates potential obstacles and develops contingency plans to minimize disruption.
What are your suggestions for how [Participant Name] can make improvements
in Management?

Supervisory Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Provides useful and constructive feedback to employees.
  1. Maintains professional interactions with peers, customers, and employees.
  1. Others emulate this supervisor's enthusiasm for work.
  1. Determines appropriate staffing levels for the job.
  1. Facilitates team members working well together.
What are your suggestions for how [Participant Name] can make improvements
in Supervisory Skills?

Professional Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Keep themselves up-to-date of technical/professional issues
  1. Contributing fully to the extent of their skills
  1. Encourages employees to take courses relevant to their job.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Seeks opportunities for professional development.
What are your suggestions for how [Participant Name] can make improvements
in Professional Development?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Strategically connects individual and team objectives to market trends.
  1. Identifies decision-making inflection points and plans interventions that shape outcomes without forcing consensus.
  1. Helps employees envision their future success within the team's broader achievements.
  1. Is able to change other people's thoughts, beliefs, and actions.
  1. Listens attentively to others to better understand their points of view.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Objectives

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ability to establish realistic goals.
  1. Encourages me to take on greater responsibility.
  1. Sets long-term and short-term goals.
  1. Consistently provides me with timely feedback for improving my performance.
  1. Establishes goals and objectives.
What are your suggestions for how [Participant Name] can make improvements
in Objectives?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Accepts responsibility for ensuring client satisfaction.
  1. Delivers customized solutions for each client.
  1. Is competent in handling client cases.
  1. Consistently meets client's needs.
  1. Fosters an environment that supports strong client focus.
What are your suggestions for how [Participant Name] can make improvements
in Client Focus?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Works to identify root causes of performance problems
  1. Takes immediate action on poor performance
What are your suggestions for how [Participant Name] can make improvements
in Co-worker Development?

Entrepreneurship

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Maintains a high level of energy to respond to demands of the job.
  1. Able to adapt the department to changing business demands and climate.
  1. Takes the initiative to complete tasks.
  1. Devotes a certain amount of time and effort to developing new business opportunities.
  1. Exhibits determination and passion in completion of goals.
What are your suggestions for how [Participant Name] can make improvements
in Entrepreneurship?

Company

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Ensures that hiring is strategic and effective.
  1. Helps employees see how their work contributes to building something enduring and meaningful.
  1. Leads efforts to ensure offerings are not only competitive but also meaningful and differentiated.
  1. Regularly evaluates equipment and systems to ensure they remain efficient and up to date.
  1. Keeps the parking area well maintained.
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.