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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
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.

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. Accepts responsibility for mistakes.
  1. Follows tasks to completion.
  1. Fosters an environment built upon trust.
  1. Establishes relationships of trust, honesty, fairness, 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. Communicates the goals and expectations for the team.
  1. Uses persuasion rather than threats of disciplinary action.
  1. Has a strong work ethic that inspires others.
  1. Provides timely and thorough performance evaluations of employees.
  1. Facilitates open communication between employees.
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. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Tells subordinates what to do, not how to do it.
  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. Allows employees to decide how they wish to complete the tasks.
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. Immediately informs the HR Department of any personnel complaints or issues.
  1. Addresses small problems before they become big ones.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Is a self-starter. Does not wait to be told to do something.
  1. Initiates draft reports for consideration.
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. Encourages commitment in others to obtain results.
  1. Creates a sense of urgency among the store team members to complete activities, which drive sales.
  1. Able to focus on a task even when working alone.
  1. Coordinates all department activities into a cohesive team effort.
  1. Takes immediate action toward goals.
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. Develops a sustainable safety culture.
  1. Participates in safety training when available.
  1. Develops a strong safety culture.
  1. Ensures that all supervisors are aware of regulatory and compliance measures.
  1. Participates in safety training as applicable.
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. 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. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Sets and clearly communicates expectations, performance goals, and measurements to others
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. Avoids engaging in conflicts over minor workplace matters.
  1. Achieves mutually acceptable solutions through collaborative efforts by both parties.
  1. Explores the feasibility of alternative solutions to resolve conflicts.
  1. Persuades individuals to alter their underlying work behaviors which may have led to the conflict.
  1. Prefers to resolve conflicts through negotiation rather than coersion.
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. Firmly believes the company is making the best offer.
  1. Is resolute in positions to build trust and predictability.
  1. Able to adapt to changing situations.
  1. Understands the motivations of the other party.
  1. Understands the current situation of both parties.
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. Gets things done through the department.
  1. Understands the current organizational culture.
  1. Able to use corporate politics to advance department objectives.
  1. Able to explain departmental policies and procedures to others.
  1. Adept at navigating within the culture of 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.