Recognition- 360 Degree Feedback Survey Sample #3





Surveys Measuring Recognition:
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.







Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is sincerely interested in the suggestions of co-workers
  1. Readily shares credit and gives others opportunity for visibility.
  1. Makes people around them feel appreciated and valued.
  1. Offers recognition in a timely manner.
  1. Lets employees know when they have done well
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. Conveys a sense of urgency about addressing problems and opportunities
  1. Displays high energy and enthusiasm on consistent basis.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Motivates others to achieve or exceed goals
Please feel free to provide any comments to help explain your answers?

Emotional Intelligence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is able to control their own emotions.
  1. Able to understand others' points of view.
  1. Is able to express themselves clearly.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Accurately perceives the emotional reactions of others.
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 authority and responsibility to subordinates and holds them accountable for their actions.
  1. Sets clear and reasonable expectations for others and follows through on their progress.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Defines goals and objectives for subordinates.
  1. Clearly defines duties and tasks to be completed.
Please feel free to provide any comments to help explain your answers?

Change Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is a leading force driving changes.
  1. Inspires others to want to change.
  1. Works cooperatively with others to implement changes.
  1. Develops plans for following through on the changes.
  1. Effective in implementing new organizational vision and values.
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. Works within constraints of the organization.
  1. Create continuity plans.
  1. Turns risks into opportunities for advancement.
  1. Effectively responds to critical situations to reduce potential for losses.
  1. Creates a risk profile for projects and teams.
Please feel free to provide any comments to help explain your answers?

Safety

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Participates in safety training when available.
  1. Supports safety programs and procedures.
  1. Encourages others to work safely.
  1. Develops a sustainable safety culture.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Honesty and integrity are core tenets of interpersonal relationships.
  1. Successfully resolves conflicts and grievances to a win-win solution.
  1. Demonstrates compassion and understanding of others.
  1. Is open and approachable
  1. Values the input from coworkers.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Able to work with others from different cultures and countries.
  1. Aligns personal vision with global strategies.
  1. Works well with others from different cultural backgrounds.
  1. Understands how cultures differ and how these differences impact work behavior.
  1. Understands and appreciates the perspectives offered by others with different cultural backgrounds.
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.