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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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. Increased customer satisfaction scores for the quarter.
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Works at a quick pace to complete a high volume of work.
  1. Makes use of talents of others to help achieve a high level of performance.
  1. Completed required training and certification.
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. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. Open to the suggestions from others.
  1. Analyzes processes to determine areas for improvement.
  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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Avoids making personal phone calls during working hours.
  1. Starts meetings on time.
  1. Responds to requests for information in a timely manner.
  1. Starts the workday when scheduled.
  1. Maintains an efficient schedule of activities.
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. Contributes to a positive work environment.
  1. Treats all people fairly and with respect.
  1. Is gracious and professional in their interactions with others.
  1. Visibly supports and encourages diversity in style and background.
  1. Builds open and trusting relationships.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Monitors timelines and milestones to ensure set benchmarks are met.
  1. Identifies the potential risks for each phase of the project.
  1. Coordinates timelines, events and tasks with various sub-groups within the project.
  1. Plans who, when, and what work needs to get done.
  1. Decides what metrics should be used as milestones 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. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Allows subordinates to use their own methods and procedures.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Allows employees to decide how they wish to complete the tasks.
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. Is flexible in addressing issues related to quality.
  1. Communicates with team members regarding best quality practices.
  1. Recognizes their role in promoting quality and safety in the workplace.
  1. Leads the department in quality improvement initiatives.
  1. Holds employees accountable for their quality of work.
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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  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. Seeks information from others as needed.
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Willingly shares information and 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. Supports employee training and development initiatives regarding implementation of technology.
  1. Understands and is committed to implementing new technologies.
  1. Adopts the implementation of new technology into the workplace.
  1. Uses technology in decision making and problem solving.
  1. Maximizes the use of new technology to deliver products and services.
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. Demonstrates a sense of responsibility and commitment to public trust.
  1. Takes ownership, delivers on commitments
  1. Is trustworthy; is someone I can trust.
  1. Consistently keeps commitments.
  1. Delivers on promises made.
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. Supports the successes of other employees.
  1. Provides constructive feedback to others.
  1. Sets performance objectives for subordinates that encourages development opportunities.
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. Keeps informed of current income and expenses.
  1. Accurately perceives potential risks to the business.
  1. Has a good understanding of liabilities and assets.
  1. Understands the costs, profits, markets, and added value of issues.
  1. Collects valuable customer insights to ensure our services meet their needs.
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. Analyzes unique issues or problems impacting the Company.
  1. Works with others to develop insights into the resources and actions required to produce desired results.
  1. Pursues strategic alliances with valued partners.
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Creates a vision for the organization based on insights gathered from other companies in the industry.
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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages employees to embrace the departmental vision.
  1. Skilled at identifying problems and envisioning effective solutions.
  1. Pinpoints specific challenges that the company faces and meticulously crafts tailored solutions to overcome these obstacles.
  1. Identifies emerging trends and anticipates future market shifts.
  1. Provides the vision needed to help the organization remain competitive and adaptable in a dynamic market.
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.