Performance - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Performance:
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)
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.







Performance

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Able to organize work.
  1. Has great overall performance
  1. Listens and responds to issues and problems
  1. Sets a high standard for job performance.
  1. Works effectively in the department.
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. Promotes an environment that fosters quality and safety.
  1. Promotes quality improvement practices in the department.
  1. Develops specific quality standards/goals to be met within a specified timeframe.
  1. Effectively works with Quality Control (QC) engineers.
  1. Develops measures of the success of quality initiatives.
Please feel free to provide any comments to help explain your answers?

Technical

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is knowledgeable of procedures or systems necessary for the job.
  1. Willingly shares information and expertise; sought out as resource by others
  1. Seeks information from others as needed.
  1. Is naturally sought out by people outside his/her particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
  1. Keeps current with technical advances within his/her professional discipline; embraces and applies new techniques and practices
Please feel free to provide any comments to help explain your answers?

Technology Use/Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Adopts the implementation of new technology into the workplace.
  1. Understands and is committed to implementing new technologies.
  1. Proficient in the use of technical systems and processes.
  1. Maximizes the use of new technology to deliver products and services.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Encourages an employee culture of continuous improvement to seek out better ways of doing things.
  1. Open to the suggestions from others.
  1. Looks for ways to improve work processes and procedures.
  1. Analyzes processes to determine areas for improvement.
  1. Looks for ways to expand and learn new job skills.
Please feel free to provide any comments to help explain your answers?

Punctuality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Conducts appointments at scheduled start time.
  1. Responds to requests for information in a timely manner.
  1. Arrives to meetings on time.
  1. Invoices clients on a timely basis.
  1. Avoids making personal phone calls during working hours.
Please feel free to provide any comments to help explain your answers?

Attitude

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Shows by their actions that they trust in the positive intentions of others.
  1. Is gracious and professional in their interactions with others.
  1. Treats all people fairly and with respect.
  1. Contributes to a positive and fun work environment.
  1. Builds open and trusting relationships.
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. Focuses on providing excellent client service.
  1. Makes sure client needs are understood by the team members.
  1. Is focused on improving client services.
  1. Helps others in responding to client needs.
  1. Ensures clients' expectations are met or exceeded.
Please feel free to provide any comments to help explain your answers?

Customer Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
  1. Makes customer's needs a top priority.
  1. Helps customers feel they are receiving services tailored specifically to their needs.
  1. Tailors solutions to meet the specific needs of each customer.
  1. Is aware of the customer's needs.
Please feel free to provide any comments to help explain your answers?

Teamwork

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Works with other team members to achieve objectives.
  1. Shares pertinent information with all members of the team.
  1. Lets team members know when they have done well.
  1. Fosters respect and understanding among team members
  1. Encourages teamwork and collaboration.
Please feel free to provide any comments to help explain your answers?

Company

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Expresses loyalty and dedication to [Company] in interactions with others.
  1. Attends [Company] gatherings and social events.
  1. Understands the use of [Company] products and services.
  1. Follows existing procedures and processes.
  1. Understands how decisions impact other business units beyond their immediate department of work group.
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.