Integrity - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Integrity:
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:
Integrity, Supervisory Skills, Delegation, Initiative, Commitment To Result, Safety, Co-worker Development, Conflict Management, Negotiation, Organizational Fluency
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.






Integrity

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Exhibits this
Competency
  1. Maintains strong relationships with others.
  1. Fosters a high standard of ethics and integrity.
  1. Demonstrates honesty and truthfulness at all times.
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Fosters an environment built upon trust.
Please feel free to provide any comments to help explain your answers?

Supervisory Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
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Competency
  1. Conducts regular progress meetings to ensure adherence to the schedule.
  1. Asks employees for their input in decisions that may directly affect the team.
  1. Offers instructions and guidance to subordinates.
  1. Exemplifies professionalism in the workplace.
  1. Reviews performance against established measures.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Defines goals and objectives for subordinates.
  1. Clearly defines duties and tasks to be completed.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Tells subordinates what to do, not how to do it.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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  1. Prepares for unexpected contingencies.
  1. Capitalizes on opportunities as they become available.
  1. Analyzes the needs of the situation and acts before being told to do so.
  1. Anticipates problems and initiates plans to address them.
  1. Looks to start work on new projects without waiting for direction from the manager.
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
Sometimes
Exhibits this
Competency
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Competency
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Competency
  1. Maintains persistence and dedication to achieving results.
  1. Able to focus on a task even when working alone.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  1. Committed to the team.
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Supports our company's safety programs.
  1. Points out behaviors in others that may be unsafe.
  1. Develops safety guidelines for the department.
  1. Ensures that all supervisors are aware of regulatory and compliance measures.
Please feel free to provide any comments to help explain your answers?

Co-worker Development

Does Not
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Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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  1. Works to identify root causes of performance problems
  1. Provides ongoing feedback to co-workers on their development progress
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
  1. Gives others development opportunities through project assignments and increased job responsibilities
  1. Takes immediate action on poor performance
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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  1. Combines ideas and viewpoints of different team members.
  1. Avoids being judgmental and micromanaging of employees.
  1. Explores the feasibility of alternative solutions to resolve conflicts.
  1. Assists team members by helping them see the other point of view.
  1. Establishes roles and responsibilities.
Please feel free to provide any comments to help explain your answers?

Negotiation

Does Not
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Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. Collects information from various stakeholders, each with their own viewpoints, data, and interests.
  1. Maintains communication channels between parties in the negotiation.
  1. Adjusts methods to suit the current situation.
  1. Is flexible in responses.
  1. Knows the BATNA (Best Alternative to a Negotiated Agreement) and is prepared to walk away if core interests are not met.
Please feel free to provide any comments to help explain your answers?

Organizational Fluency

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Able to explain departmental policies and procedures to others.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Effective in communicating with others within the organization.
  1. Gets things done through the department.
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.