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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Maintains strong relationships with others.
  1. Fosters an environment built upon trust.
  1. Follows tasks to completion.
  1. Does what was promised.
  1. Fosters a high standard of ethics and integrity.
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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Completes assessments in a timely manner.
  1. Is clear when assigning tasks to be completed.
  1. Provides feedback referencing specific instances or examples of behaviors.
  1. Is respectful toward employees.
  1. Exemplifies professionalism in the workplace.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Defines goals and objectives for subordinates.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
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
Always
Exhibits this
Competency
  1. Initiates draft documents for the director.
  1. Immediately informs the supervisor of any critical incidents.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Looks to start work on new projects without waiting for direction from the manager.
  1. Engages with new customers immediately.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Maintains persistence and dedication to achieving results.
  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.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Coordinates all department activities into a cohesive team effort.
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. Encourages others to work safely.
  1. Develops safety guidelines for the department.
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Supports our company's safety programs.
  1. Participates in safety training when offered.
Please feel free to provide any comments to help explain your answers?

Co-worker Development

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  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
  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?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Clearly expresses expectations to others.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Deals effectively with employee grievances.
  1. Discusses conflict situations with supervisor.
Please feel free to provide any comments to help explain your answers?

Negotiation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
  1. Able to say "no" when it is essential to maintaining quality and high standards.
  1. Stays calm and focuses on the core issues to be discussed.
  1. Establishes good working relationships with others.
  1. Is able to decline bad ideas to avoid making poor decisions.
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. Effective in communicating with others within the organization.
  1. Understands the current organizational culture.
  1. Understands departmental policies and procedures.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
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.