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Self-Management - 360 Degree Feedback Survey Sample #5





360-Degree Assessment Survey

Questionnaires Measuring Self:
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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Self Management

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Does not allow own emotions to interfere with the performance of others.
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Steps away from a situation to process appropriate response.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.


Creativity

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Conceives, implements and evaluates ideas.
  1. Develops solutions to challenging problems.
  1. Is creative.
  1. Creates a lot of new ideas.
  1. Is creative and inspirational.


Cultural Awareness

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Helps other employees to become more culturally sensitive.
  1. Recognizes individual and cultural differences.
  1. Develops skills and attitudes to bridge cultural differences.
  1. Is open and honest in communications with individuals from other cultures.
  1. Values the diverse perspectives from others.


Problem Solving

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Works diligently until the problem is solved.
  1. Continuously monitors performance after implementing a solution to ensure it remains effective.
  1. Develops creative solutions.
  1. Demonstrates unwavering persistence even when facing setbacks.
  1. Actively seeks the root cause of a problem.


Juggling Multiple Responsibilities

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Ranks the importance of tasks to make sure critical tasks are completed first.
  1. Completes multiple tasks simultaneously.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Begins tasks as soon as possible.
  1. Assigns tasks based on skills of team members.


Clarity

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Attends to the important details of a job or task.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Maintains clarity in goals and objectives.
  1. Clearly explains the vision and goals of the company.


Regulatory/Compliance

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Effectively communicates the importance of meeting compliance standards.
  1. Develops regulatory compliance strategies.
  1. Creates and implements training courses for new hires to ensure knowledge of regulations and policies.
  1. Reviews the compliance program and recommends changes based on new industry trends.
  1. Is aware of federal and local laws affecting employees.


Partnering/Networking

Role
Model
Capable and
Effective
Somewhat
Effective
Needs
Development
  1. Regularly attends conferences and seminars to meet with others in the industry.
  1. Uses new techniques and procedures learned through established networks of professionals.
  1. Expands network of colleagues to include others who may contribute to the department's success.
  1. Promotes the understanding of how the department affects the organization overall.
  1. Is an active member of professional associations or professional groups to stay connected with peers.



  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.