Empowering Others- 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Empowering Others:
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 selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months and the goals they were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be discussed with the employee to foster growth and on-going 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.

Please ensure that your submission is made between . The survey will only be available during these dates.


Empowering Others

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Permits employees to take training to become more independent.
  1. Gives employees the authority to act on their own.
  1. Trusts employees with important responsibilities.
  1. Allows employees the opportunity to take time off when needed.
  1. Is aware of the skill levels of employees and assigns tasks that are at the appropriate skill level.
What are your suggestions for how [Participant Name] can make improvements
in Empowering Others?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Has excellent influencing/negotiating skills.
  1. Attempts to persuade others rather than simply control them.
  1. Persuades others to consider alternative points of view.
  1. Ensures stakeholders are involved in the decision making process.
  1. Seeks to obtain consensus or compromise.
What are your suggestions for how [Participant Name] can make improvements
in Persuasion and Influence?

Continual Learning

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Sets relevant learning objectives and goals.
  1. Is open to new ideas and concepts.
  1. Builds on their strengths while addressing their weaknesses.
  1. Pursues professional development opportunities when they arise.
  1. Shares best practices with others and learns from others.
What are your suggestions for how [Participant Name] can make improvements
in Continual Learning?

Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Takes responsibility for things that go wrong
  1. Sets an example for others to follow
  1. Delegate tasks effectively
  1. Keep staff informed about what is happening in the company
  1. Makes you feel enthusiastic about your work
What are your suggestions for how [Participant Name] can make improvements
in Management?

Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Shown significant improvement in job performance.
  1. ...Produce Quality
  1. Works well in this position.
  1. Listens and responds to issues and problems
  1. ...Overall Performance
What are your suggestions for how [Participant Name] can make improvements
in Performance?

Punctuality

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Responds to requests for information in a timely manner.
  1. Avoids making personal phone calls during working hours.
  1. Starts meetings on time.
  1. Maintains an efficient schedule of activities.
  1. Invoices clients on a timely basis.
What are your suggestions for how [Participant Name] can make improvements
in Punctuality?

Time Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Combines tasks to save time.
  1. Uses a calendar effectively to keep track of when events or milestones are supposed to occur.
  1. Rarely misses deadlines; often producing results before expected.
  1. Proactively addresses crucial matters.
  1. Does not procrastinate.
What are your suggestions for how [Participant Name] can make improvements
in Time Management?

Achievement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Sets challenging goals for the department.
  1. Completed training on the new equipment.
  1. Driven to complete goals despite obstacles that may arise.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
What are your suggestions for how [Participant Name] can make improvements
in Achievement?

Conflict Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Persuades individuals to alter their underlying work behaviors which may have led to the conflict.
  1. Works to reduce misunderstandings and poor communication.
  1. Persuades others to accept personal transformation.
  1. Strives to ensure that all basic needs are met, resulting in mutual benefits for both parties.
  1. Identifies the root cause of the problems.
What are your suggestions for how [Participant Name] can make improvements
in Conflict Management?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. Develops budgets and plans for various programs and initiatives.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Provides budgeting and accounting support to the Company.
  1. Monitors expenses and verifies the need for items purchased.
  1. Monitors spending.
What are your suggestions for how [Participant Name] can make improvements
in Fiscal Management?


  1. Strengths


  2. Areas for Development


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