Action - 360 Degree Feedback Survey Sample #3

Questionnaires Measuring Action:
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)

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.

Competencies Included:
Action, Establishing Focus/Direction, Supervisory Skills, Initiative, Managing Risk, Regulatory/Compliance, Co-worker Development, Others, Organizational Fluency

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 a great company.

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

Overall, please rate the effectiveness of .

5- Very Effective

4- Effective

3- Neither

2- Ineffective

1- Very Ineffective
Strengths
Areas for Development
Please give any final comments or suggestions for 's assessment.

Action	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Makes effective decisions, even when under pressure.
Drives and mobilizes others progress toward goals.
Motivates & supports others to gain skills
Gets the job done.
Does whatever it takes (within reason) to get the job done.
Please feel free to provide any comments to help explain your answers?

Establishing Focus/Direction	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Excellent at managing time.
Helps guide employees with prioritizing tasks.
Makes sure that employees understand how their work relates to organizational goals.
Maintains focus when handling several problems or tasks simultaneously.
Maintains self-control when personally criticized.
Please feel free to provide any comments to help explain your answers?

Supervisory Skills	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Provides constructive, ongoing feedback.
Promotes teamwork and cooperation within the department.
Encourages employees to achieve their full potential.
Delegates effectively.
Appropriately recognizes and rewards employees.
Please feel free to provide any comments to help explain your answers?

Initiative	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Takes decisive action to address problems, following up with relevant team members and coaching them on how to improve.
Takes action without being asked.
Prepares for unexpected contingencies.
Takes the initiative to change the direction or course of events.
Immediately works to complete goals well before their deadline.
Please feel free to provide any comments to help explain your answers?

Managing Risk	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Rewards innovative experiments to try new ideas.
Bases decisions on patterns found in fluid/changing information.
Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
Seeks to retain the best and brightest employees.
Maintains open communication with other departments.
Please feel free to provide any comments to help explain your answers?

Regulatory/Compliance	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Performs audits regularly, or without notice, to ensure proper compliance with regulations.
Understands and adheres to internal and external regulations.
Maintains a state of readiness to address new and changing regulations and procedures.
Reviews skill levels of employees in areas of policies and regulations to identify gaps where additional training is needed.
Addresses issues quickly before they develop into major problems.
Please feel free to provide any comments to help explain your answers?

Co-worker Development	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Please feel free to provide any comments to help explain your answers?

Others	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Is able to see issues from others' perspectives.
Able to see issues from others' perspectives.
Constructively receives criticism and suggestions from others.
Supports the efforts of other employees in implementing solutions to problems.
...treats others with respect and dignity.
Please feel free to provide any comments to help explain your answers?

Organizational Fluency	Does Not Exhibit this Competency	Seldom Exhibits this Competency	Sometimes Exhibits this Competency	Usually Exhibits this Competency	Always Exhibits this Competency
Is aware of other organizational cultures to compare/contrast with the current organizational culture.
Understands the current organizational culture.
Adept at navigating within the culture of the department.
Able to explain departmental policies and procedures to others.
Able to use corporate politics to advance department objectives.
Please feel free to provide any comments to help explain your answers?