Company- 360 Degree Feedback Survey Sample #3





Competencies Included:
Company, Integrity, Professional Development, Managing Performance, Persuasion and Influence, Decision Making, Initiative, Achievement, Safety, Recognition
Surveys Measuring Company:
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.




Company

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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  1. Follows existing procedures and processes.
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Impresses upon others the important aspects of [Company].
Please feel free to provide any comments to help explain your answers?

Integrity

Does Not
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Competency
Seldom
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  1. Fosters a high standard of ethics and integrity.
  1. Develops trust and confidence from others.
  1. Demonstrates sincerity in actions with others.
  1. Maintains strong relationships with others.
  1. Fosters an environment built upon trust.
Please feel free to provide any comments to help explain your answers?

Professional Development

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  1. Quickly acquire and apply new knowledge and skills when needed
  1. Keep themselves up-to-date of technical/professional issues
  1. Contributing fully to the extent of their skills
  1. Seeks opportunities for professional development.
  1. Seeks opportunities for continuous learning.
Please feel free to provide any comments to help explain your answers?

Managing Performance

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  1. Establishes standards for expected performance.
  1. Initiates a performance improvement plan for underperforming subordinates.
  1. Makes sure the team's goals are met.
  1. Is consistent in clearly communicating job requirements.
  1. Monitors performance on a regular basis.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

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  1. Able to express own goals and needs.
  1. Communicates effectively with others.
  1. Seeks to obtain consensus or compromise.
  1. Has excellent influencing/negotiating skills.
  1. Ensures stakeholders are involved in the decision making process.
Please feel free to provide any comments to help explain your answers?

Decision Making

Does Not
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  1. Is open to listening to others who may have different ideas.
  1. Makes decisions that support the department's goals and objectives.
  1. Makes decisions based on novel interpretations of the facts.
  1. Understands how their decisions will affect others.
  1. Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Please feel free to provide any comments to help explain your answers?

Initiative

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  1. Confronts problems immediately without supervisor instructions.
  1. Engages with new customers immediately.
  1. Anticipates problems and initiates plans to address them.
  1. Goes above and beyond the stated goals.
  1. Takes advantage of opportunities when they become available.
Please feel free to provide any comments to help explain your answers?

Achievement

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  1. Demonstrates a sense of urgency to quickly and accurately solve problems and issues.
  1. Takes immediate action of projects that fall behind schedule.
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Highly motivated to achieve or exceed performance standards.
  1. Allocates resources as needed to accomplish organizational goals.
Please feel free to provide any comments to help explain your answers?

Safety

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  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Seeks to reduce the likelihood of accidents.
  1. Keeps accurate safety records.
  1. Mitigates hazards and safety issues that arise.
  1. Points out behaviors in others that may be unsafe.
Please feel free to provide any comments to help explain your answers?

Recognition

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  1. Recognizes individuals for a specific outstanding achievement.
  1. Makes people around them feel appreciated and valued.
  1. Compliments other people when they do good work
  1. Recognizes the abilities and skills of self and others
  1. Lets employees know when they have done well
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.