HR-Survey > 360-Degree Feedback > Competency Model > Responsibility

Responsibility - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Responsibility:
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)
Self-Assessment Instructions

Leadership at [Company] are participating in a 360-Degree Feedback assessment. As part of this process, you need to complete a self-assessment questionnaire form. 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.

Competencies Included:
Responsible, Continual Learning, Continual Improvement, Quality, Juggling Multiple Responsibilities, Results Oriented, Interpersonal Skills, Coaching, Conflict Management, Global Perspective
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.






Responsible

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
Always
Exhibits this
Competency
  1. You complete assigned work tasks.
  1. You are a person others can trust.
  1. You set high personal standards of performance.
  1. You act as a resource without removing individual responsibility.
  1. Your behavior is ethical and honest.
Please feel free to provide any comments to help explain your answers?

Continual Learning

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Exhibits this
Competency
  1. You seek opportunities to grow in skills and knowledge.
  1. You improve on your skill sets.
  1. You pursue learning that will enhance job performance.
  1. You share best practices with others and learn from others.
  1. You pursue professional development opportunities when they arise.
Please feel free to provide any comments to help explain your answers?

Continual Improvement

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. You promote training and development opportunities to enhance job performance.
  1. You look for ways to expand current job responsibilities.
  1. You analyze processes to determine areas for improvement.
  1. You search for new methods, techniques, and processes that increase efficiency and reduce costs.
  1. You encourage an employee culture of continuous improvement to seek out better ways of doing things.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
Always
Exhibits this
Competency
  1. I lead the department in quality improvement initiatives.
  1. I competently and accurately analyze quality measures.
  1. I am flexible in addressing issues related to quality.
  1. I verify the correct materials were used in the installation.
  1. You promote an environment that fosters quality and safety.
Please feel free to provide any comments to help explain your answers?

Juggling Multiple Responsibilities

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You begin tasks as soon as possible.
  1. You coordinate the work of a team by assigning tasks to other team members.
  1. You prioritize tasks for efficiency.
  1. You assign tasks based on skills of team members.
  1. You organize tasks for the most efficient order of completion.
Please feel free to provide any comments to help explain your answers?

Results Oriented

Does Not
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Competency
Seldom
Exhibits this
Competency
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Competency
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Competency
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Exhibits this
Competency
  1. You concentrate efforts on the most urgent needs.
  1. I measure progress toward the goal.
  1. You set the objectives for the team.
  1. I help the team maintain focus on the goals.
  1. You pursues performance benchmarks despite obstacles and setbacks.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
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Competency
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Competency
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Competency
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Competency
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Competency
  1. You demonstrate compassion and understanding of others.
  1. I am willing to lend a hand to those in the department who need help.
  1. You are easily approachable.
  1. I keep commitments made with coworkers.
  1. I value the input from coworkers.
Please feel free to provide any comments to help explain your answers?

Coaching

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. You meet regularly with employees to coach them on areas that will enhance your performance
  1. You address employee behavior problems effectively.
  1. You provide clear, motivating, and constructive feedback.
  1. You coach employees in how to strengthen knowledge and skills to improve work performance.
  1. You conduct regular performance appraisals and feedback.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. I promote mutual compromise to achieve conflict resolution.
  1. I create an environment where team members work collaboratively rather than compete with one another.
  1. You facilitate constructive dialog with stakeholders.
  1. I seeks to have both sides voluntarily work together to resolve their differences.
  1. You identify and takes steps to prevent potential confrontations.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. You are able to work with others from different cultures and countries.
  1. You demonstrate working knowledge of global transactions.
  1. You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
  1. You communicate effectively on a multi-lingual basis.
  1. You demonstrate a curiosity about diverse individuals and cultures.
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.