Passion to Learn - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Passion to Learn:
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.







Passion To Learn

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Enhances value to the company through additional training and development.
  1. Is open minded and curious about learning new skills.
  1. Embraces new technology and procedures.
  1. Enjoys learning new skills and techniques.
  1. Is open to feedback from others.
Please feel free to provide any comments to help explain your answers?

Supervisory Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Conveys instructions, directives and guidelines to the employees.
  1. Encourages employees to take responsibility for mistakes.
  1. Makes sure employees are accomplishing important objectives.
  1. Is clear about the expectations that employees will be held accountable for.
  1. Provides feedback referencing specific instances or examples of behaviors.
Please feel free to provide any comments to help explain your answers?

Delegation

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Clearly defines duties and tasks to be completed.
  1. Tells subordinates what to do, not how to do it.
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. Understands and uses established quality procedures/controls.
  1. Successfully implements quality controls within the department.
  1. Creates effective policies regarding quality of services and products.
  1. Communicates with team members regarding best quality practices.
  1. Ensures high consistency across batches or production runs.
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. Takes advantage of opportunities when they become available.
  1. Acts with urgency when time is limited.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Acts on own initiative to improve the department outcomes.
  1. Takes the initiative to change the direction or course of events.
Please feel free to provide any comments to help explain your answers?

Managing Risk

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
  1. Minimizes the increase in costs due to global events or supply chain issues.
  1. Determines the impact of specific risks on infrastructure.
  1. Tracks and monitors incidents that may increase the risk of adverse consequences.
  1. Accurately perceives potential risks in the workplace and initiates preventative measures.
Please feel free to provide any comments to help explain your answers?

Regulatory/Compliance

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Knows who to contact at various regulatory agencies if needed.
  1. Implements regulatory changes in a timely manner.
  1. Develops compliance reports in accordance with federal and industry regulations.
  1. Ensures appropriate followup for regulatory violations.
  1. Understands the applicable regulations and laws that impact our business.
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. Assesses employees' developmental needs.
  1. Is open to receiving feedback.
  1. Tries to ensure employees are ready to move to the next level.
  1. Recognizes and celebrates accomplishments of others.
  1. Creates opportunities for professional development.
Please feel free to provide any comments to help explain your answers?

Organizational Fluency

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understands departmental policies and procedures.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Able to explain departmental policies and procedures to others.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Effective in communicating with others within the organization.
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.