Leadership - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Leadership:
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:
Leadership, Persuasion and Influence, Quality, Initiative, Trustworthy, Self Management, Conflict Management, Recognition, Others
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.




Leadership

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Influences the decisions made at the Company.
  1. Communicates calmly and honestly even when stressed.
  1. Empowers others to succeed within their jobs.
  1. Able to influence others.
  1. Is a highly effective supervisor.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understanding what others need.
  1. Able to express own goals and needs.
  1. Ensures stakeholders are involved in the decision making process.
  1. Seeks to obtain consensus or compromise.
  1. Persuades others to consider alternative points of view.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Always strives to produce the highest quality work products.
  1. Reflects on what is working and what could be improved.
  1. Encourages others to produce the highest quality work products.
  1. Encourages others to achieve high quality standards.
  1. Encourages employees to produce the best quality products.
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 projects that have an impact on the department.
  1. Cleans the workspace without being told.
  1. Looks to start work on new projects without waiting for direction from the manager.
  1. Begins immediate action on projects.
  1. Inspires others to perform above expectations.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Works in a way that makes others want to work with her/him.
  1. Demonstrates congruence between statements and actions.
  1. Builds and maintains the trust of others.
  1. Is trustworthy; is someone I can trust.
  1. Consistently keeps commitments.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  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. Does not allow own emotions to interfere with the performance of others.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Consciously controls own negative emotions in order to keep team morale up.
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. Identifies and takes steps to prevent potential confrontations.
  1. Tries to understand others' point of view before making judgments
  1. Assists team members by helping them see the other point of view.
  1. Discusses conflict situations with supervisor.
  1. Clearly expresses expectations to others.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Finds opportunities to recognize others.
  1. Offers recognition in a timely manner.
  1. Recognizes team members who offer a significant contribution to a project.
  1. Readily shares credit and gives others opportunity for visibility.
  1. Compliments other people when they do good work
Please feel free to provide any comments to help explain your answers?

Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Works effectively with people from other departments.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Works across boundaries within the organization.
  1. Is able to see issues from others' perspectives.
  1. Constructively receives criticism and suggestions from others.
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.