HR-Survey > 360-Degree Feedback > Competency Model

Passion to Learn - 360 Degree Feedback Survey Sample #4





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)
Dear Employee:

Welcome to our 360-Degree Feedback self-assessment questionnaire. Our objective is to provide feedback which will help advance your leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify areas where you are doing well and where you have opportunities to do better. Others will also complete the questionnaire to provide you with feedback.

We have developed this survey with questions tailored for your position in the department to provide you with an opportunity to rate many facets of your leadership performance.

Sample Result Document:
Sample Results
Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.


Passion To Learn

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You will participate in training classes even if offered outside of normal working hours.
  1. You inspire others to learn new things.
  1. You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
  1. You are committed to enhancing your own knowledge and skills.
  1. You enjoy learning new skills and techniques.

Cultural Awareness

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. I am aware of differences in how individuals from other cultures greet one another.
  1. You communicate with others without the influence of racism.
  1. I recognize individual and cultural differences.
  1. You understand how implicit biases can affect decisions, communication and productivity.
  1. I am willing to include individuals with different cultural backgrounds on the team.

Bias for Action

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You identify ways to simplify work processes and reduce cycle times
  1. You convey a sense of urgency about addressing problems and opportunities
  1. You coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. You project a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. You complete work on time

Performance

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You produce quality
  1. You have great overall performance
  1. You are effective in performing your job.
  1. You set a high standard for job performance.
  1. You effectively organize resources and plans

Flexibility

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You are effective in incorporating new ideas.
  1. You can handle changes without complaining.
  1. You encourage others to adopt new procedures.
  1. You implement changes as a result of having listened to employees
  1. You are open to the perspectives/viewpoints of others.

Adaptability

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You are able to adjust to changes as needed.
  1. You easily accept new responsibilities.
  1. You can adjust plans and procedures.
  1. You are open to new ideas and innovations.
  1. You are flexible and open minded in dealing with others.

Problem Solving

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You find creative ways to get things done with limited resources.
  1. You make judgments based upon relevant information.
  1. You work cooperatively with others to solve problems.
  1. You solve problems using logic and insight.
  1. You identify and assess all potential responses to a problem.

Initiative

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. I take corrective action to rectify issues.
  1. I act quickly when a small problem arises to keep it from becoming a major issue.
  1. I capitalize on opportunities as they become available.
  1. You confront problems immediately without supervisor instructions.
  1. I address small problems before they become big ones.

Results Oriented

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You explain the "whys" behind organizational objectives
  1. You set important goals for the department.
  1. You hold yourself and others accountable for achieving results.
  1. Completed work exceeds standards.
  1. You exceed performance requirements.

Safety

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You encourage others to work safely.
  1. You participate in safety training when available.
  1. You mitigate hazards and safety issues that arise.
  1. You keep accurate safety records.
  1. You participate in safety training as applicable.

Responsible

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You set high personal standards of performance.
  1. You are a person others can trust.
  1. You hold yourself accountable to goals / objectives
  1. You act as a resource without removing individual responsibility.
  1. You are responsible for setting the vision of the department.

Coaching

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You conduct regular performance appraisals and feedback.
  1. You coach employees in how to strengthen knowledge and skills to improve work performance.
  1. You meet regularly with employees to coach them on areas that will enhance your performance
  1. You develop the skills and capabilities of others.
  1. You address employee behavior problems effectively.

Partnering/Networking

Needs
Significant
Development
1
2 Capable
and
Effective
3
4 Role
Model
5
  1. You promote the understanding of how the department affects the organization overall.
  1. You develop a sense of trust in subordinates so they can freely interact and share information with others.
  1. You maintain infrastructure to support partnerships and networks.
  1. You collaborate with others to accomplish goals and objectives.
  1. You partner with peers to obtain influence within the Company.


  1. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?






  2. Would you refer others who are seeking employment to [Company]?


    Please provide explanation:


  3. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?



  4. What changes do you see [Company] making in order to raise the standards?


  5. I feel good about my continued employment with [Company].


    If no, please provide explanation:



  6. What do you like best about working for [Company]?


  7. What do you like least about working for [Company]? How could it be improved?

  8. Use the space below to enter any final comments you would like to be noted: