Feedback - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Feedback:
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:
Feedback, Attitude, Cultural Awareness, Project Management, Decision Making, Commitment To Result, Professional Development, Technical, Trustworthy, Co-worker Development, 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.






Feedback

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
Always
Exhibits this
Competency
  1. Shares past experiences with others as learning opportunities.
  1. Looks to others for input.
  1. Is easy to approach with ideas and opinions.
  1. Considers other's opinion and suggestions.
  1. Asks others for their ideas and opinions.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
  1. Builds open and trusting relationships.
  1. Contributes to a positive work environment.
  1. Contributes to a positive and fun work environment.
  1. Treats all people fairly and with respect.
  1. Is gracious and professional in their interactions with others.
Please feel free to provide any comments to help explain your answers?

Cultural Awareness

Does Not
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Competency
Seldom
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Competency
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  1. Recognizes and values individual and cultural differences.
  1. Engages with individuals that have different cultural backgrounds.
  1. Willing to work with employees who have different cultural backgrounds.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Open to learning about different cultures.
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
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Competency
Seldom
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Competency
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  1. Able to adjust project schedule as needed to accommodate unforeseen issues.
  1. Creates the implementation strategy for the project.
  1. Successfully negotiated contracts with suppliers.
  1. Identifies the project time and budget constraints.
  1. Plans who, when, and what work needs to get done.
Please feel free to provide any comments to help explain your answers?

Decision Making

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Is firm in their decision and not easily influenced by the whims of others.
  1. Examines relevant factors needed to make a decision.
  1. Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
  1. Gathers information before making a decision.
  1. Identifies parameters impacting the decision.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Maintains persistence and dedication to achieving results.
  1. Committed to the team.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
Please feel free to provide any comments to help explain your answers?

Professional Development

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Allows employees to fully participate in employee training and professional development.
  1. Seeks opportunities for professional development.
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Seeks opportunities for continuous learning.
  1. Contributing fully to the extent of their skills
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Knows how to produce high quality products/work.
  1. Willingly shares information and expertise; sought out as resource by others
  1. Willingly shares his/her technical expertise; sought out as resource by others
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Seeks information from others as needed.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
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Competency
Seldom
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Competency
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  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Delivers on promises made.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Takes ownership, delivers on commitments
  1. Consistently keeps commitments.
Please feel free to provide any comments to help explain your answers?

Co-worker Development

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Competency
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Competency
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Competency
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  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Provides ongoing feedback to co-workers on their development progress
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Works to identify root causes of performance problems
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
Please feel free to provide any comments to help explain your answers?

Vision

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
  1. Designs and implements a forward-looking vision for the company.
  1. Delegates the task of implementing the vision to subordinates.
  1. Builds a strategic vision by analyzing the company's current position and the market environment, identifying strengths, weaknesses, opportunities, and threats.
  1. Creates a timeline to fulfill the organization's vision.
  1. Promotes a vision that inspires individuals to take risks to achieve greater rewards.
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.