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
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Competency
Seldom
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  1. Accepts the views of others.
  1. Is visible and approachable.
  1. Seeks feedback to enhance performance.
  1. Is easy to approach with ideas and opinions.
  1. Actively seeks feedback from others.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
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Competency
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  1. Contributes to a positive work environment.
  1. Treats all people fairly and with respect.
  1. Builds open and trusting relationships.
  1. Works to eliminate unnecessary work or barriers that get in others' way.
  1. Visibly supports and encourages diversity in style and background.
Please feel free to provide any comments to help explain your answers?

Cultural Awareness

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  1. Respects the views offered by individuals with different cultural backgrounds.
  1. Interacts effectively with people from different cultural backgrounds.
  1. Shows respect in daily interactions
  1. Functions effectively within various cultural contexts.
  1. Communicates with others without the influence of racism.
Please feel free to provide any comments to help explain your answers?

Project Management

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  1. Develops action items, workplans, timelines, and criteria for projects.
  1. Formulates the schedule for the project phases, resoures usage, and benchmarks.
  1. Responds quickly and appropriately to unforeseen problems.
  1. Accurately determines the number of staff needed for the project.
  1. Communicates the results of the project, at the conclusion, to all stakeholders.
Please feel free to provide any comments to help explain your answers?

Decision Making

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  1. Has a good rapport other people which is helpful in making decisions on the team.
  1. Formulates imaginative decisions.
  1. Asks for additional information when making critical decisions.
  1. Views the long and short-term impact of decisions.
  1. Outlines the parameters influencing the decision making process.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

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  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Coordinates all department activities into a cohesive team effort.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Maintains persistence and dedication to achieving results.
  1. Able to focus on a task even when working alone.
Please feel free to provide any comments to help explain your answers?

Professional Development

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  1. Keep themselves up-to-date of technical/professional issues
  1. Seeks opportunities for continuous learning.
  1. Quickly acquire and apply new knowledge and skills when needed
  1. Contributing fully to the extent of their skills
  1. Seeks opportunities for professional development.
Please feel free to provide any comments to help explain your answers?

Technical

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  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. Willingly shares his/her technical expertise; sought out as resource by others
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
  1. Uses expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
  1. Is knowledgeable of procedures or systems necessary for the job.
Please feel free to provide any comments to help explain your answers?

Trustworthy

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  1. Delivers on promises made.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Is trustworthy; is someone I can trust.
  1. Takes ownership, delivers on commitments
  1. Demonstrates congruence between statements and actions.
Please feel free to provide any comments to help explain your answers?

Co-worker Development

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  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Takes immediate action on poor performance
  1. Works to identify root causes of performance problems
  1. Provides ongoing feedback to co-workers on their development progress
Please feel free to provide any comments to help explain your answers?

Vision

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  1. Demonstrates consistency between words and actions
  1. Behaves in a way that is consistent with business values & code of conduct
  1. Communicates a vision of where the Company needs to be in the future.
  1. Develops action plans to align his/her work with the goals of the organization
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
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.