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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.

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.



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Integrity

Does Not
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Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
  1. Protects the integrity and confidentiality of information
  1. Fosters a high standard of ethics and integrity.
  1. Establishes relationships of trust, honesty, fairness, and integrity.
  1. Demonstrates sincerity in actions with others.
  1. Develops trust and confidence from others.
Please feel free to provide any comments to help explain your answers?

Supervisory Skills

Does Not
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Competency
Seldom
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Competency
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  1. Communicates effectively with employees.
  1. Effectively uses rewards to help motivate employees.
  1. Provides detailed feedback to employees.
  1. Completes assessments in a timely manner.
  1. Is fair and equitable in enforcement of work rules.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
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Competency
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  1. Allows subordinates to use their own methods and procedures.
  1. Tells subordinates what to do, not how to do it.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Assigns tasks to create learning opportunities for the employees.
  1. Entrusts subordinates with important tasks.
Please feel free to provide any comments to help explain your answers?

Initiative

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  1. Looks to start work on new projects without waiting for direction from the manager.
  1. Seizes upon opportunities available.
  1. Is a self-starter. Does not wait to be told to do something.
  1. Anticipates problems and initiates plans to address them.
  1. Quickly comes to the aid of those who may need help.
Please feel free to provide any comments to help explain your answers?

Commitment To Result

Does Not
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Competency
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Competency
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  1. Maintains persistence and dedication to achieving results.
  1. Willing to do whatever it takes-not afraid to have to put in extra effort.
  1. Takes immediate action toward goals.
  1. Encourages commitment in others to obtain results.
  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
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Competency
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  1. Develops a culture of safety.
  1. Identifies and addresses safety needs.
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Participates in safety training when available.
  1. Develops a strong safety culture.
Please feel free to provide any comments to help explain your answers?

Co-worker Development

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  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. Adapts coaching and mentoring approach to meet the style or needs of individuals
  1. Works to identify root causes of performance problems
Please feel free to provide any comments to help explain your answers?

Conflict Management

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  1. Seeks to avert the recurrence of conflict issues.
  1. Establishes roles and responsibilities.
  1. Prefers to resolve conflicts through negotiation rather than coersion.
  1. Listens to individuals as they offer their unique perspectives on the situation.
  1. Facilitates collaborative processes to reduce conflict.
Please feel free to provide any comments to help explain your answers?

Negotiation

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Competency
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  1. Identifies verbal and nonverbal cues to help interpret actions and messages.
  1. Keeps emotions in check to avoid negative outbursts.
  1. Clearly communicates boundaries and the reasons behind them.
  1. Is able to decline bad ideas to avoid making poor decisions.
  1. Influences others through rational argument and persuasion.
Please feel free to provide any comments to help explain your answers?

Organizational Fluency

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Competency
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Competency
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  1. Understands departmental policies and procedures.
  1. Gets things done through the department.
  1. Anticipates problems that may affect the department.
  1. Able to use corporate politics to advance department objectives.
  1. Effective in communicating with others within the organization.
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.