Empowering Others - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

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)

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.

Empowering Others

Definite Strength Meets Standards Needs Development N/A
  1. Gives responsibility for making important decisions to employees.
  1. Recognizes the accomplishments of employees when they complete important assignments.
  1. Expresses confidence in the abilities of others.
  1. Ensures employees understand what is being assigned to them.
  1. Supports the decisions of others.

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Provides employees with necessary resources to accomplish their goals.
  1. Addresses poor performance sooner rather than later.
  1. Routinely holds audits of performance on a weekly or monthly basis.
  1. Acknowledges employee contributions that support the bottom line.
  1. Establishes indicators to measure levels of performance.


Definite Strength Meets Standards Needs Development N/A
  1. Treats all people fairly and with respect.
  1. Contributes to a positive and fun work environment.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Visibly supports and encourages diversity in style and background.


Definite Strength Meets Standards Needs Development N/A
  1. Entrusts subordinates with important tasks.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Clearly defines duties and tasks to be completed.

Problem Solving

Definite Strength Meets Standards Needs Development N/A
  1. Implements effective solutions to critical problems.
  1. Works cooperatively with others to solve problems.
  1. Understands the root causes of problems.
  1. Ability to solve problems at root cause rather than at symptom level.
  1. Identifies and assesses all potential responses to a problem.

Juggling Multiple Responsibilities

Definite Strength Meets Standards Needs Development N/A
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Begins tasks as soon as possible.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Switches attention to more urgent tasks when necessary.
  1. Avoids bottlenecks in progress by assigning multiple individuals to critical tasks.


Definite Strength Meets Standards Needs Development N/A
  1. Demonstrates the analytical skills to do their job.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Can be counted on to add value wherever they are involved.
  1. Is planful and organized.
  1. Keeps themselves and others focused on constant improvement.

Client Focus

Definite Strength Meets Standards Needs Development N/A
  1. Forms strong client relationships
  1. Satisfies client needs.
  1. Maintains strong relationships with clients.
  1. Looks for opportunities that have a positive impact on Clients.
  1. Is pro-active in dealing with clients and addressing their needs.


Definite Strength Meets Standards Needs Development N/A
  1. Understands the use of [Company] products and services.
  1. Attends [Company] gatherings and social events.
  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. Expresses loyalty and dedication to [Company] in interactions with others.

  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.