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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)
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.

Competencies Included:
Coaching, Professional Development, Feedback, Persuasion and Influence, Action, Bias for Action, Delegation, Change Management, Juggling Multiple Responsibilities, Objectives, Conflict Management, Teamwork
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.



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Coaching

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Conducts regular performance appraisals and feedback.
  1. Addresses employee behavior problems effectively.
  1. Provides clear, motivating, and constructive feedback.
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. Contributing fully to the extent of their skills
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Keep themselves up-to-date of technical/professional issues
  1. Allows employees to fully participate in employee training and professional development.
  1. Encourages employees to take courses relevant to their job.
Please feel free to provide any comments to help explain your answers?

Feedback

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
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Competency
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Competency
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Exhibits this
Competency
  1. Considers other's opinion and suggestions.
  1. Shares past experiences with others as learning opportunities.
  1. Looks to others for input.
  1. Actively seeks feedback from others.
  1. Seeks feedback to enhance performance.
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. Able to express own goals and needs.
  1. Understanding what others need.
  1. Attempts to persuade others rather than simply control them.
  1. Develops a good rapport with others.
  1. Ensures stakeholders are involved in the decision making process.
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. Takes on additional responsibilities outside of the job description to help the team succeed.
  1. Effectively handles multiple complex issues simultaneously.
  1. Does whatever it takes (within reason) to get the job done.
  1. Navigates organizational structures and boundaries to achieve goals.
  1. Leverages skills and resources to exceed expectations on projects.
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. Conveys a sense of urgency about addressing problems and opportunities
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Motivates others to achieve or exceed goals
  1. Completes work on time
  1. Completes a large volume of work.
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. Tells subordinates what to do, not how to do it.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  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?

Change Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Addresses organizational and departmental resistance to changes.
  1. Supports the Company's efforts to implement changes.
  1. Adopts changes to set and example for others to follow.
  1. Is an inspiration for others to accept the recent changes.
  1. Effective in dealing with ambiguous and challenging situations.
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. Prioritizes tasks for efficiency.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
  1. Coordinates the work of a team by assigning tasks to other team members.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
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
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Competency
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Exhibits this
Competency
  1. Establishes goals and objectives.
  1. Effectively organizes resources and plans
  1. Communicates goals and objectives to employees.
  1. Able to organize work.
  1. Consistently provides me with timely feedback for improving my performance.
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. Identifies areas of agreement and common ground.
  1. Identifies who holds the authority to make decisions.
  1. Addresses concerns about the availability of limited resources.
  1. Initates collaborative processes to reduce conflict.
  1. Assists team members by helping them see the other point of view.
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. Coaches team members
  1. Works with other team members on the project.
  1. Makes sure each team member participates in the task.
  1. Listens carefully to other team members.
  1. Shares pertinent information with all members of the team.
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.