Empowering Others- 360 Degree Feedback Survey Sample #3





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)
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.

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.







Empowering Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Assigns tasks that allow employees to use their critical thinking skills.
  1. Includes others in the decision making process.
  1. Recognizes the expertise that employees have in certain areas and allows them the freedom to operate as they see fit.
  1. Encourages employees to take on greater responsibilities.
  1. Values the expertise that others bring to the team.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Makes people around them feel appreciated and valued.
  1. Recognizes team members who offer a significant contribution to a project.
  1. Compliments other people when they do good work
  1. Lets employees know when they have done well
  1. Recognizes the abilities and skills of self and others
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. Able to produce goods and services across a wide spectrum of business needs.
  1. Is flexible in solving difficult problems.
  1. Promotes flexibility in approaches by encouraging employees to think outside the box and experiment with new methods and ideas.
  1. Able to adapt and tailor approaches based on the unique requirements of each scenario.
  1. Supports a flexible culture that values continuous improvement and innovation.
Please feel free to provide any comments to help explain your answers?

Accountability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Can be counted on to do what they say they are going to do.
  1. Exhibits a sense of ownership of outcomes and results.
  1. Shows up for work on time.
  1. Takes responsibility for errors and actively works to correct them.
  1. Accepts responsibility to lead efforts to solving critical problems.
Please feel free to provide any comments to help explain your answers?

Continual Learning

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Takes charge of their training and skills enhancement.
  1. Takes the initiative to learn new skills.
  1. Pursues professional development opportunities when they arise.
  1. Sets relevant learning objectives and goals.
  1. Grasps new ideas, concepts, technical, or business knowledge.
Please feel free to provide any comments to help explain your answers?

Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delegate tasks effectively
  1. Takes responsibility for things that go wrong
  1. Makes you feel enthusiastic about your work
  1. Is ready to offer help
  1. Sets an example for others to follow
Please feel free to provide any comments to help explain your answers?

Innovation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Uses unconventional approaches to solve problems.
  1. Creates innovative solutions to critical problems facing the Company.
  1. Seeks innovative ways to change, grow, and improve the department.
  1. Ensures that employees feel safe to take risks and experiment without the fear of failure or retribution.
  1. Establishes measurable innovation goals and regularly track progress to maintain focus and momentum.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Holds herself / himself accountable to goals / objectives
  1. Sets a good example
  1. Completes assigned work tasks.
  1. Sets a good example.
  1. Behavior is ethical and honest.
Please feel free to provide any comments to help explain your answers?

Vision

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Defines an ideal image for what the department should look like in the future.
  1. Recognizes potential challenges and devises comprehensive strategies to navigate and mitigate these difficulties.
  1. Provides vision and strategies to the team.
  1. Develops a vision to inspire collective action.
  1. Builds a strategic vision by analyzing the company's current position and the market environment, identifying strengths, weaknesses, opportunities, and threats.
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.