Coaching- 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Coaching:
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.





Coaching

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Addresses employee behavior problems effectively.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Helps employees to maintain high personal standards.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Helps employees to understand responsibilities, authority, and expectations.
Please feel free to provide any comments to help explain your answers?

Professional Development

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Allows employees to fully participate in employee training and professional development.
  1. Seeks opportunities for professional development.
  1. Quickly acquire and apply new knowledge and skills when needed
  1. Seeks opportunities for continuous learning.
Please feel free to provide any comments to help explain your answers?

Feedback

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Considers other's opinion and suggestions.
  1. Looks to others for input.
  1. Is easy to approach with ideas and opinions.
  1. Accepts the views of others.
  1. Asks others for their ideas and opinions.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Communicates effectively with others.
  1. Persuades others to consider alternative points of view.
  1. Seeks to obtain consensus or compromise.
  1. Attempts to persuade others rather than simply control them.
  1. Develops a good rapport with others.
Please feel free to provide any comments to help explain your answers?

Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Drives and mobilizes others progress toward goals.
  1. Is decisive when making decisions.
  1. Persists in work despite obstacles encountered.
  1. Takes steps to prepare for the start of the project.
  1. Is proactive in developing solutions to problems.
Please feel free to provide any comments to help explain your answers?

Bias for Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages risk taking and experimentation to improve performance
  1. Completes a large volume of work.
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Displays high energy and enthusiasm on consistent basis.
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. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Allows employees to decide how they wish to complete the tasks.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Tells subordinates what to do, not how to do it.
Please feel free to provide any comments to help explain your answers?

Change Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Able to get team members to change their attitudes.
  1. Supports the Company's efforts to implement changes.
  1. Able to get department employees to accept new changes.
  1. Adopts changes to set and example for others to follow.
  1. Works cooperatively with others to implement changes.
Please feel free to provide any comments to help explain your answers?

Juggling Multiple Responsibilities

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Builds in extra time in the schedule for unplanned events/occurrences.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
  1. Uses a scheduler/planner to keep tasks organized and on time.
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Communicates goals and objectives to employees.
  1. Able to organize work.
  1. Ability to establish realistic goals.
  1. Establishes goals and objectives.
  1. Works toward achieving established goals and objectives.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Assists team members by helping them see the other point of view.
  1. Tries to understand others' point of view before making judgments
  1. Identifies and takes steps to prevent potential confrontations.
  1. Deals effectively with employee grievances.
  1. Helps employees to think through alternative ways to resolve conflict situations.
Please feel free to provide any comments to help explain your answers?

Teamwork

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Helps the team exercise good judgment by making sound and informed decisions.
  1. Treats other team members with respect.
  1. Lets team members know when they have done well.
  1. Committed to the successful completion of team goals.
  1. Acts as an effective team player
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.