Initiative - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Initiative:
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)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. 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:
Initiative, Communication Skills, Action, Self Management, Management, Project Management, Delegation, Partnering/Networking, Business Acumen, Strategic Insight, Global Perspective
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.




Initiative

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. I address small problems before they become big ones.
  1. You take on extra projects after required work is completed.
  1. You anticipate what needs to be done and makes necessary preparations.
  1. You take the initiative to change the direction or course of events.
  1. You immediately work to complete goals well before your deadline.
Please feel free to provide any comments to help explain your answers?

Communication Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You communicate effectively with all levels of the organization.
  1. You deal with difficult situations calmly and confidently.
  1. You listen to others' points of view with an open mind
  1. You give clear and convincing presentations.
  1. You coach others and provides feedback on the use of different oral communication styles for different audiences
Please feel free to provide any comments to help explain your answers?

Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. I rapidly adapt to changes in the situation.
  1. You assign tasks to individuals who are most able to perform them.
  1. I focus on tasks without being distracted.
  1. I am the first to volunteer for assignments.
  1. You work at a quick pace.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. You deal with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. You do not allow own emotions to interfere with the performance of others.
  1. You consciously control own negative emotions in order to keep team morale up.
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. You set an example for others to follow
  1. You make others feel enthusiastic about your work
  1. You keep staff informed about what is happening in the company
  1. You delegate tasks effectively
  1. You take responsibility for things that go wrong
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You conduct a risk assessment for each phase of the project.
  1. You coordinate timelines, events and tasks with various sub-groups within the project.
  1. I can develop a plan for resource management.
  1. You develop performance measures for various aspects of the project.
  1. I create a risk management plan and periodically updates it as the project moves forward.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
Usually
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Competency
Always
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Competency
  1. You entrust subordinates with important tasks.
  1. You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. You clearly define duties and tasks to be completed.
  1. You set clear and reasonable expectations for others and follow through on their progress.
  1. You define goals and objectives for subordinates.
Please feel free to provide any comments to help explain your answers?

Partnering/Networking

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You partner with peers to obtain influence within the Company.
  1. You forge mutually beneficial relationships between individuals with diverse backgrounds.
  1. You seek an understanding of diverse functions within the Company.
  1. You maintain infrastructure to support partnerships and networks.
  1. You seek to reduce institutional roadblocks to information sharing.
Please feel free to provide any comments to help explain your answers?

Business Acumen

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
Usually
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Competency
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Competency
  1. You understand financial terminology, statements.
  1. I have an understanding of various asset classes and how to interpret balance sheets.
  1. You are up-to-date with regulatory guidelines and policies.
  1. You periodically assess the current market environment.
  1. You keep informed of current income and expenses.
Please feel free to provide any comments to help explain your answers?

Strategic Insight

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
Always
Exhibits this
Competency
  1. You anticipate business cycles and trends and makes adjustments in a timely manner.
  1. You adjust strategic plans based on insights gathered from different points of view.
  1. You create strategies that significantly benefit the Company.
  1. I develop a strategic vision for the future.
  1. You understand how to strategically grow the business and increase customers.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You are aware of the culture, behaviors, identities and beliefs of others.
  1. You collaborate with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
  1. You create an environment where individual differences are valued and supported.
  1. You volunteer for experiences and assignments abroad.
  1. You analyze global issues/problems that are having a large impact on the Company.
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.