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. Focuses team efforts on meeting the needs of the customers.
  1. Fosters an environment that values initiative and creativity.
  1. Sets a high level of performance expectations and challenges others to do the same.
  1. Seeks input and ideas from employees by involving them in decisions.
  1. Inspires, encourages, and guides others toward the vision, mission, and goals.
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. Develops a good rapport with others.
  1. Ensures stakeholders are involved in the decision making process.
  1. Attempts to persuade others rather than simply control them.
  1. Able to express own goals and needs.
  1. Has excellent influencing/negotiating skills.
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. Consistently provides timely, accurate, and reliable information on quality measures.
  1. Positively influences others to strive to attain high quality standards.
  1. Reflects on what is working and what could be improved.
  1. Holds employees accountable for their quality of work.
  1. Competently and accurately analyzes quality measures.
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 works on solving problems.
  1. Looks for opportunities to move projects forward.
  1. Expands the offerings of the department by working evenings and weekends.
  1. Acts with urgency when time is of the essence.
  1. Anticipates what needs to be done and makes necessary preparations.
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. Takes ownership, delivers on commitments
  1. Consistently keeps commitments.
  1. Builds and maintains the trust of others.
  1. Takes care to maintain confidential information.
  1. Delivers on promises made.
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. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Steps away from a situation to process appropriate response.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Uses patience and self-control in working with customers and associates.
  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. Listens to individuals as they offer their unique perspectives on the situation.
  1. Helps others avoid misperceptions.
  1. Views conflicts as opportunities to create constructive and novel solutions to problems.
  1. Seeks to remove misperceptions that may contribute toward conflict.
  1. Works to settle conflicts in a manner that is acceptable for a long-term solution.
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. Recognizes individuals for a specific outstanding achievement.
  1. Offers recognition in a timely manner.
  1. Says "thank you" to show appreciation for work of others.
  1. Recognizes the abilities and skills of self and others
  1. Is sincerely interested in the suggestions of co-workers
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. Helpful
  1. Able to see issues from others' perspectives.
  1. Consistently demonstrates ability and willingness to trust others.
  1. Works across boundaries within the organization.
  1. Supports the efforts of other employees in implementing solutions to problems.
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.