Commitment to Result - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Commitment to Results:
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.

Competencies Included:
Commitment To Result, Flexibility, Creativity, Cultural Awareness, Performance, Change Management, Objectives, Teamwork, Planning
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.






Commitment To Result

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Coordinates all department activities into a cohesive team effort.
  1. Committed to the team.
  1. Able to focus on a task even when working alone.
  1. Encourages commitment in others to obtain results.
Please feel free to provide any comments to help explain your answers?

Flexibility

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is able to recover from setbacks.
  1. Implements changes as a result of having listened to employees
  1. Embraces change, values feedback, and is willing to experiment with different methods to find the most effective solutions.
  1. Acts decisively in frequently changing and uncertain environment.
  1. Is open to and values diverse perspectives.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is creative.
  1. Inspires creativity in their team.
  1. Develops solutions to challenging problems.
  1. Conceives, implements and evaluates ideas.
  1. Is creative and inspirational.
Please feel free to provide any comments to help explain your answers?

Cultural Awareness

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Engages with individuals that have different cultural backgrounds.
  1. Participates in cultural training sessions/classes.
  1. Understands the impact that our culture may have on interactions between individuals.
  1. Is responsive to individuals from other cultures.
  1. Understands how their own cultural background can impact the way they communicate and interact with others.
Please feel free to provide any comments to help explain your answers?

Performance

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Shown significant improvement in job performance.
  1. Effectively organizes resources and plans
  1. ...Overall Performance
  1. ...Produce Quality
  1. Has great overall performance
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. Is a leading force driving changes.
  1. Assists others in understanding changes to the organization.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Develops plans for following through on the changes.
  1. Develops a strategy for implementing changes.
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. Ability to establish realistic goals.
  1. Organizes and schedules events, activities, and resources.
  1. Establishes goals and objectives.
  1. Able to organize work.
  1. Sets long-term and short-term goals.
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 other team members to research solutions to a problem.
  1. Helps the team decide what long term goals need to be met.
  1. Creates opportunities to learn with other team members
  1. Carries his/her share of the workload
  1. Shares credit for accomplishments with team members
Please feel free to provide any comments to help explain your answers?

Planning

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understands what equipment will be needed for the project.
  1. Initiates the planning process by defining the scope of the project.
  1. Allows input from others for the 5-year plan.
  1. Determines the amount of materials/supplies needed for the project.
  1. Develops a strategic plan to reduce costs in the department.
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.