HR-Survey > 360-Degree Feedback > Competency Model

Initiative - 360 Degree Feedback Survey Sample #4





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)
Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Sample Result Document:
Sample Results
Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.


Initiative

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Initiates important conversation topics at meetings.
  1. Creates solutions to problems as soon as an incident occurs.
  1. Builds strong interpersonal relationships upon first meeting.
  1. Gladly seeks additional responsibilities.
  1. Guides strategic initiatives to advance the department/organization.

Accountability

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Chooses integrity over convenience.
  1. Fully embraces the responsibilities that contribute to our departmental success.
  1. Exhibits a sense of ownership of outcomes and results.
  1. Projects an image of transparency and trustworthiness in the administration of fair and equitable policies.
  1. Welcomes the responsibility for meeting the broad range of needs of stakeholders and clients.

Integrity

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Demonstrates sincerity in actions with others.
  1. Maintains strong relationships with others.
  1. Protects the integrity and confidentiality of information
  1. Follows tasks to completion.
  1. Develops trust and confidence from others.

Self Management

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.

Passion To Learn

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Is open minded and curious about learning new skills.
  1. Demonstrates through personal behavior the commitment to high standards of performance.
  1. Takes advantage of training opportunities when they arise.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Will participate in training classes even if offered outside of normal working hours.

Supervisory Skills

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Fosters an environment that supports open communication.
  1. Implements disciplinary policy in accordance with the union contract
  1. Successfully mediates conflicts between employees.
  1. Offers non-monetary rewards as incentives for employees.
  1. Oversees employees to make sure their work is performed up to standard.

Analytical

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Prioritizes various actions to be taken when solving a problem.
  1. Balances risks and costs with the rewards and probabilities of success when decisions.
  1. Uses appropriate techniques to solve problems.
  1. Analyzes issues and reduces them to their component parts.
  1. Identifies opportunities for progress and innovation.

Decision Making

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Learns from previous bad decisions and rarely repeats them.
  1. Defines parameters that will impact the decision making process.
  1. Receptive to new ideas from others when making decisions.
  1. Weighs the pros and cons of decisions.
  1. Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action

Customer Focus

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Is competent in handling difficult customers.
  1. Develops strong customer relationships.
  1. Is committed to resolving customer issues in a positive way.
  1. Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
  1. Focuses on providing excellent customer service.

Company

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. Understands the use of [Company] products and services.
  1. Understands the "basics" as to how [Company] functions/operates.
  1. Follows existing procedures and processes.
  1. Impresses upon others the important aspects of [Company].
  1. Attends [Company] gatherings and social events.


  1. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?






  2. Would you refer others who are seeking employment to [Company]?


    Please provide explanation:


  3. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?



  4. What changes do you see [Company] making in order to raise the standards?


  5. I feel good about my continued employment with [Company].


    If no, please provide explanation:



  6. What do you like best about working for [Company]?


  7. What do you like least about working for [Company]? How could it be improved?

  8. Use the space below to enter any final comments you would like to be noted: