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. Helps others to improve or meet standards of performance.
  1. Sets ambitious standards of performance.
  1. Successfully launched the ABC project.
  1. Is results oriented.
  1. Completes work to given time frame and to budget
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 expand current job responsibilities.
  1. Open to the suggestions from others.
  1. Analyzes processes to determine areas for improvement.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Conducts appointments at scheduled start time.
  1. Maintains an efficient schedule of activities.
  1. Arrives to meetings on time.
  1. Invoices clients on a timely basis.
  1. Starts meetings on time.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Treats all people fairly and with respect.
  1. Contributes to a positive and fun work environment.
  1. Builds open and trusting relationships.
  1. Is gracious and professional in their interactions with others.
  1. Shows by their actions that they trust in the positive intentions of others.
Please feel free to provide any comments to help explain your answers?

Project Management

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. Develops a plan for resource management.
  1. Uses appropriate software tools to assist in managing the project.
  1. Monitors finances to ensure optimal use of project funds.
  1. Creates the implementation strategy for the project.
  1. Presents clear and accurate status information to required constituents.
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. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Corrects issues in a timely manner.
  1. Holds employees accountable for their quality of work.
  1. Encourages others to achieve high quality standards.
  1. Encourages employees to produce the best quality products.
  1. Reflects on what is working and what could be improved.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
Always
Exhibits this
Competency
  1. Demonstrates mastery of the technical competencies required in his/her work.
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  1. Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
  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. Willingly shares his/her technical expertise; sought out as resource by others
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
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Maximizes the use of new technology to deliver products and services.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Adopts the implementation of new technology into the workplace.
  1. Uses technology in decision making and problem solving.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delivers on promises made.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Takes care to maintain confidential information.
  1. Consistently keeps commitments.
  1. Demonstrates congruence between statements and actions.
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. Creates opportunities for professional development.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Assesses employees' developmental needs.
  1. Encourages employees through recognition of positive changes in behavior.
  1. Supports the successes of other employees.
Please feel free to provide any comments to help explain your answers?

Business Acumen

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Recognizes trends in underlying data.
  1. Understands cash flow procedures and statements.
  1. Aware of regulations that impact our business.
  1. Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
  1. Understands the costs, profits, markets, and added value of issues.
Please feel free to provide any comments to help explain your answers?

Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Attends industry conferences to gain further insight into how other companies deal with similar issues.
  1. Implements long-term solutions to problems.
  1. Works with others to develop insights into the resources and actions required to produce desired results.
  1. Maintains knowledge of current trends in the industry.
  1. Converses with customers and clients to get a better insight into their personal needs.
Please feel free to provide any comments to help explain your answers?

Vision

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Exhibits this
Competency
  1. Creates a common vision for others.
  1. Develops action plans to align his/her work with the goals of the organization
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Creates a positive vision of the future for the Company.
  1. Clearly articulates a vision for his/her work and inspires others to support it
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.