Others- 360 Degree Feedback Survey Sample #3





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)
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.

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
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Treats others with respect and dignity.
  1. Works across boundaries within the organization.
  1. Includes others in the decision making processes.
  1. Respects the opinions of other employees.
  1. Forms working relationships with employees from other departments.
Please feel free to provide any comments to help explain your answers?

Empowering Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages employees to think outside the box.
  1. Allows employees to make their own decisions.
  1. Encourages employees to solve problems on their own.
  1. Views others in the department as valued assets to be trained and employed.
  1. Demonstrates confidence in the abilities of subordinates.
Please feel free to provide any comments to help explain your answers?

Developing Others

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is open to receiving feedback.
  1. Sets performance objectives for subordinates that encourages development opportunities.
  1. Assigns tasks and responsibilities to develop skills of others.
  1. Creates opportunities for professional development.
  1. Tries to ensure employees are ready to move to the next level.
Please feel free to provide any comments to help explain your answers?

Communication Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Considers the audience in how the communication is presented.
  1. Keeps the supervisor informed about achievements and milestones.
  1. Persuasive and articulate when communicating.
  1. Communicates with department leadership
  1. Summarizes or paraphrases the current question to confirm understanding.
Please feel free to provide any comments to help explain your answers?

Bias for Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Motivates others to achieve or exceed goals
  1. Displays high energy and enthusiasm on consistent basis.
  1. Completes work on time
  1. Identifies ways to simplify work processes and reduce cycle times
Please feel free to provide any comments to help explain your answers?

Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delegate tasks effectively
  1. Makes you feel enthusiastic about your work
  1. Keep staff informed about what is happening in the company
  1. Takes responsibility for things that go wrong
  1. Sets an example for others to follow
Please feel free to provide any comments to help explain your answers?

Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Motivated to exceed performance goals.
  1. Helps others to improve or meet standards of performance.
  1. Sets challenging goals for the department.
  1. Increased production by 20 percent.
  1. Takes reasonable risks to achieve desired results.
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Has excellent communication with clients.
  1. Keeps the client informed of all progress.
  1. Is pro-active in dealing with clients and addressing their needs.
  1. Prioritizes client issues to tackle the most pressing needs first.
  1. Focuses on the unique needs of each client.
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.