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)
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.


Responsible

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. ...takes personal responsibility for results.
  1. Holds herself / himself accountable to goals / objectives
  1. Responsible for setting the vision of the department.
  1. Sets a good example
  1. Completes assigned work tasks.
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. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Is able to express themselves clearly.
  1. Is able to control their own emotions.
  1. Is able to manage 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. Is ready to offer help
  1. Takes responsibility for things that go wrong
  1. Keep staff informed about what is happening in the company
  1. Makes you feel enthusiastic about your work
  1. Sets an example for others to follow
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. Maintains good working relationships with employees.
  1. Leads others through their commitment to the department.
  1. Values the opinions of subordinates.
  1. Follows the company standard procedures for allocating assignments.
  1. Delegates effectively.
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. Quickly acquire and apply new knowledge and skills when needed
  1. Seeks opportunities for continuous learning.
  1. Seeks opportunities for professional development.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Contributing fully to the extent of their skills
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. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.
  1. Seeks to obtain consensus or compromise.
  1. Develops a good rapport with others.
  1. Able to express own goals and needs.
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. Consistently provides me with timely feedback for improving my performance.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Able to organize work.
  1. Encourages me to take on greater responsibility.
  1. Works toward achieving established 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. Anticipates client needs.
  1. Tailors solutions to meet the specific needs of each client.
  1. Regularly receives positive feedback from clients.
  1. Understands the needs of the client.
  1. Manages client accounts with high degree of competence.
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. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Works to identify root causes of performance problems
  1. Provides ongoing feedback to co-workers on their development progress
  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. Has a strategic awareness on how to promote the organization.
  1. Is comfortable operating in an environment of uncertainty.
  1. Can work effectively in an environment of uncertainty.
  1. Devotes a certain amount of time and effort to developing new business opportunities.
  1. Understands the processes and various stages of business development.
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. Attends [Company] gatherings and social events.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Understands the use of [Company] products and services.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
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.