Delegation - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Delegation:
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)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.


Definite Strength Meets Standards Needs Development N/A
  1. Assigns tasks to create learning opportunities for the employees.
  1. Clearly defines duties and tasks to be completed.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Entrusts subordinates with important tasks.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Does not become flustered by deadlines and timelines.
  1. Focuses on tasks that have high priority.
  1. Avoids distractions in the workplace.
  1. Sets clearly defined goals.
  1. Sets a good balance between work and family life.


Definite Strength Meets Standards Needs Development N/A
  1. Can be counted on to do what they say they are going to do.
  1. Acts like an owner when they make decisions.
  1. Holds team accountable to meeting goals.
  1. Defines roles, rights, and responsibilities of the team.
  1. Encourages employees to take on greater responsibilities.

Continual Learning

Definite Strength Meets Standards Needs Development N/A
  1. Grasps new ideas, concepts, technical, or business knowledge.
  1. Is open to new ideas and concepts.
  1. Pursues self-improvement through continual learning.
  1. Shares best practices with others and learns from others.
  1. Builds on their strengths while addressing their weaknesses.

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Is attentive to emotional cues and interprets others' feelings correctly.
  1. Able to understand others' points of view.
  1. Is able to control their own emotions.
  1. Is able to manage their own emotions.
  1. Is able to express themselves clearly.

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Addresses poor performance sooner rather than later.
  1. Measures performance of goals and objectives.
  1. Provides employees with necessary resources to accomplish their goals.
  1. Aligns individual and team goals with the organization's goals and objectives.
  1. Recognizes and values good performance.

Results Oriented

Definite Strength Meets Standards Needs Development N/A
  1. Does not become distracted by non-issues or interruptions.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Directs team in prioritizing daily work activities
  1. Works toward achievement of goals even when confronted with obstacles.


Definite Strength Meets Standards Needs Development N/A
  1. Develops a sustainable safety culture.
  1. Develops a strong safety culture.
  1. Identifies and addresses safety needs.
  1. Points out behaviors in others that may be unsafe.
  1. Ensures compliance with safety regulations.


Definite Strength Meets Standards Needs Development N/A
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.
  1. Provides clear, motivating, and constructive feedback.
  1. Conducts regular performance appraisals and feedback.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Addresses employee behavior problems effectively.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.