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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)
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:
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.



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Leadership

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. Gives inspiring presentations or discussions.
  1. Says "no" to strategies that will detract from the organization's objectives.
  1. Coaches others and prepares them for current and future business demands.
  1. Sets goals and objectives that exceed those of peers or team members.
  1. Selects the best and brightest people from inside or outside the company.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
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Competency
Seldom
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Competency
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  1. Stays focused on evidence even in emotionally charged discussions, modeling composure and integrity.
  1. Effectively communicates a point of view.
  1. Earns the respect of employees by consistently doing what they ask of others - modeling the behavior they wish to see.
  1. Exposes employees to new information, observations, or experiences to influence their thinking.
  1. Serves as a go-to resource within the organization, shaping opinions through consistent, reliable expertise.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
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Competency
Seldom
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Competency
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  1. Makes sure cleanliness standards are met to reduce the possibility of contamination.
  1. Takes preventative measures to address quality issues before they escalate.
  1. Able to anticipate quality issues and take preventative actions.
  1. Develops measures of the success of quality initiatives.
  1. Evaluates and improves the quality of services and products.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
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Competency
Seldom
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Competency
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  1. Takes actions without having to be told to do so.
  1. When working on a problem in a team, they are often the first to suggest possible solutions.
  1. Immediately informs the supervisor of any critical incidents.
  1. Is proactive when preparing for potential problems or critical events.
  1. Addresses small problems before they become big ones.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
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Competency
Seldom
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Competency
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  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Takes care to maintain confidential information.
  1. Consistently keeps commitments.
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Delivers on promises made.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Steps away from a situation to process appropriate response.
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
Please feel free to provide any comments to help explain your answers?

Conflict Management

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Competency
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Competency
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  1. Explains rules for engagement.
  1. Values the diverse perspectives of others.
  1. Seeks to achieve mutually acceptable outcomes.
  1. Gathers patterns from conversations that inform broader organizational improvements.
  1. Responds calmly and courteously to help de-escalate situations and lead to more productive and respectful dialogue showcasing effective conflict resolution skills.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
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  1. Accompanies recognition with specific examples of how the employee's work made a difference for the department/organization.
  1. Lets employees know when they have done well
  1. Develops recognition events that reward and motivate others.
  1. Is transparent in communication about recognition programs and awards.
  1. Implements formal and informal recognition practices within the department.
Please feel free to provide any comments to help explain your answers?

Others

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  1. Consistently demonstrates ability and willingness to trust others.
  1. Works across boundaries within the organization.
  1. Forms working relationships with employees from other departments.
  1. Helpful
  1. Includes others in the decision making processes.
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.