Achievement - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Achievement:
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 asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

Please ensure that your submission is made between . The survey will only be available during these dates.







Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Completes work promptly and efficiently.
  1. Sets performance metrics to measure achievement or attainment of goals.
  1. Inspires others to work with a sense of urgency.
  1. Successfully launched the ABC project.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Looks for ways to improve work processes and procedures.
  1. Analyzes processes to determine areas for improvement.
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Open to the suggestions from others.
  1. Looks for ways to expand and learn new job skills.
Please feel free to provide any comments to help explain your answers?

Punctuality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Exhibits this
Competency
  1. Invoices clients on a timely basis.
  1. Maintains an efficient schedule of activities.
  1. Arrives to meetings on time.
  1. Responds to requests for information in a timely manner.
  1. Avoids making personal phone calls during working hours.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Treats all people fairly and with respect.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Visibly supports and encourages diversity in style and background.
  1. Contributes to a positive work environment.
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. Inspires the project implementation team to achieve success.
  1. Keeps stakeholders informed of progress on the project.
  1. Implements risk mitigation strategies to help move the project to successful completion.
  1. Documents the sequence of steps needed to complete the project.
  1. Locates the equipment and supplies needed for the project.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Allows subordinates to use their own methods and procedures.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Tells subordinates what to do, not how to do it.
  1. Clearly defines duties and tasks to be completed.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
Always
Exhibits this
Competency
  1. Positively influences others to strive to attain high quality standards.
  1. Holds employees accountable for their quality of work.
  1. Communicates with team members regarding best quality practices.
  1. Engages and leads staff in implementation of new quality procedures.
  1. Is innovative and creative in response to issues involving quality of the products.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
Always
Exhibits this
Competency
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  1. Knows how to produce high quality products/work.
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Demonstrates mastery of the technical competencies required in his/her work.
Please feel free to provide any comments to help explain your answers?

Technology Use/Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Competency
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Adopts the implementation of new technology into the workplace.
  1. Supports technical training and development of employees.
  1. Maximizes the use of new technology to deliver products and services.
  1. Proficient in the use of technical systems and processes.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. Is a person you can trust.
  1. Demonstrates congruence between statements and actions.
  1. Takes ownership, delivers on commitments
  1. Takes care to maintain confidential information.
  1. Is trustworthy; is someone I can trust.
Please feel free to provide any comments to help explain your answers?

Developing Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Sets performance objectives for subordinates that encourages development opportunities.
  1. Assesses employees' developmental needs.
  1. Supports the successes of other employees.
  1. Creates opportunities for professional development.
  1. Provides constructive feedback to others.
Please feel free to provide any comments to help explain your answers?

Business Acumen

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understands cash flow procedures and statements.
  1. Understands the costs, profits, markets, and added value of issues.
  1. Considers environmental, social, and governance (ESG) factors to ensure the business is sustainable in the long run.
  1. Views problems from a business perspective, opportunity, investment, risks, and anticipated results
  1. Is up-to-date with regulatory guidelines and policies.
Please feel free to provide any comments to help explain your answers?

Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
Usually
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Competency
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Exhibits this
Competency
  1. Develops a plan and strategy for each functional area within the mission statement.
  1. Communicates with employees to find out their needs.
  1. Analyzes unique issues or problems impacting the Company.
  1. Maintains knowledge of current trends in the industry.
  1. Pursues strategic alliances with valued partners.
Please feel free to provide any comments to help explain your answers?

Vision

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. Provides the vision needed to help the organization remain competitive and adaptable in a dynamic market.
  1. Provides staff with the necessary resources, authority, and support to effectively implement and achieve the organization's vision.
  1. Tasks employees with realizing the vision.
  1. Effectively communicates the vision to employees.
  1. Able to see trends in the business environment.
Please feel free to provide any comments to help explain your answers?

  1. Overall, please rate the effectiveness of [Participant Name].






  2. Strengths


  3. Areas for Development


  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.