Others- 360 Degree Feedback Survey Sample #3





Competencies Included:
Others, Empowering Others, Developing Others, Communication Skills, Bias for Action, Management, Achievement, Client Focus
Surveys Measuring Others:
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.

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.






Others

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Able to see issues from others' perspectives.
  1. Respects the opinions of other employees.
  1. Works across boundaries within the organization.
  1. ...treats others with respect and dignity.
  1. Constructively receives criticism and suggestions from others.
Please feel free to provide any comments to help explain your answers?

Empowering Others

Does Not
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Competency
Seldom
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  1. Empowers employees to structure their work hours to maximize their productivity.
  1. Demonstrates confidence in the abilities of subordinates.
  1. Gives responsibility for making important decisions to employees.
  1. Allows employees to organize their schedule to best accomplish the job.
  1. Creates a culture where employees are given the opportunity to take the initiative and make impactful decisions.
Please feel free to provide any comments to help explain your answers?

Developing Others

Does Not
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  1. Provides constructive feedback to others.
  1. Creates opportunities for professional development.
  1. Supports the successes of other employees.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Creates a work environment that fosters positive feedback to employees.
Please feel free to provide any comments to help explain your answers?

Communication Skills

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Competency
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  1. Prepares and delivers presentations.
  1. Writes complete and developmentally-oriented performance appraisals with clear goals, using SMART criteria
  1. Able to deliver presentations.
  1. Able to communicate ideas effectively and succinctly to both individuals and groups, in any setting.
  1. Maintains a formal and respectful tone, avoiding use of slang or overly casual language.
Please feel free to provide any comments to help explain your answers?

Bias for Action

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  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Completes work on time
  1. Completes a large volume of work.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Encourages risk taking and experimentation to improve performance
Please feel free to provide any comments to help explain your answers?

Management

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Competency
Seldom
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  1. Delegate tasks effectively
  1. Sets an example for others to follow
  1. Is ready to offer help
  1. Keep staff informed about what is happening in the company
  1. Makes you feel enthusiastic about your work
Please feel free to provide any comments to help explain your answers?

Achievement

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Seldom
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  1. Is determined to complete tasks regardless of obstacles that may occur.
  1. Motivated to exceed performance goals.
  1. Completed training on the new equipment.
  1. Allocates resources as needed to accomplish organizational goals.
  1. Completes work to a high technical standard
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
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  1. Is pro-active in dealing with clients and addressing their needs.
  1. Has received good feedback from clients.
  1. Is aware of what the client wants to receive.
  1. Focuses on providing excellent client service.
  1. Adapts to changing client needs.
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.