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)
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:
Empowering Others, Recognition, Flexibility, Accountability, Continual Learning, Management, Innovation, Responsible, Vision
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. Gives new tasks to employees.
  1. Listens to the ideas employees have for solving issues.
  1. Gives employees important tasks to expand their career options.
  1. Willing to share in the decision making process.
  1. Lets employees make their own decisions.
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. Readily shares credit and gives others opportunity for visibility.
  1. Recognizes the abilities and skills of self and others
  1. Recognizes individuals for a specific outstanding achievement.
  1. Reinforces and rewards employees for accomplishing necessary goals.
  1. Is sincerely interested in the suggestions of co-workers
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. Adapts processes and procedures in response to changes in the work environment.
  1. Is flexible in solving difficult problems.
  1. Allows for flexibility in setting realistic performance goals.
  1. Able to make changes to their leadership style after receiving constructive feedback through the performance review.
  1. Open to adapting thoughts, behaviors, and strategies in response to evolving situations and new information.
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. Expects employees to account for their actions and performance.
  1. Holds employees accountable for their participation in solving department problems and issues.
  1. Keeps supervisor informed of recent events.
  1. Willingly accepts the consequences for their actions.
  1. Ensures that employee objectives are aligned with the organization's objectives.
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. Is open to new ideas and concepts.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Pursues professional development opportunities when they arise.
  1. Takes the initiative to learn new skills.
  1. Builds on their strengths while addressing their weaknesses.
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. Keep staff informed about what is happening in the company
  1. Makes you feel enthusiastic about your work
  1. Sets an example for others to follow
  1. Is ready to offer help
  1. Delegate tasks effectively
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. Challenges current procedures to develop other alternatives.
  1. Solves problems with insight and understanding.
  1. Fosters a creative and innovative work environment.
  1. Creates a safe environment for idea-sharing.
  1. Finds creative ways to get things done with limited resources.
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. Completes assigned work tasks.
  1. Sets a good example.
  1. Sets high personal standards of performance.
  1. Sets a good example
  1. Responsible for setting the vision of the department.
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. Develops and executes a strategic vision for the organization.
  1. Plans a roadmap for the department's growth and expansion.
  1. Designs a forward-thinking strategy to achieve the department's growth goals.
  1. Defines a roadmap for realizing the organization's vision.
  1. Develops an inspiring and ambitious vision for the organization's future.
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.