Strategic Insight- 360 Degree Feedback Survey Sample #3





Competencies Included:
Strategic Insight, Entrepreneurship, Global Perspective, Adaptability, Self Management, Emotional Intelligence, Achievement, Objectives, Safety, Recognition
Surveys Measuring Strategic Insight:
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)
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.

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.






Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You strategically align projects to the goals of the company.
  1. I observe employees at work to get better insight into the issues they are dealing with.
  1. You understand how to strategically grow the business and increase customers.
  1. I recognize the needs of customers.
  1. You let employees know how their roles contribute toward the achievement of strategic company objectives.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You exhibit determination and passion in completion of goals.
  1. You can work effectively in an environment of uncertainty.
  1. You know when to listen to the advice of others.
  1. You set business policies and procedures.
  1. You have a strategic awareness on how to promote the organization.
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. You set the example for team on importance of cultural awareness.
  1. You analyze global issues/problems that are having a large impact on the Company.
  1. You volunteer for experiences and assignments abroad.
  1. You collaborate with others respectfully and effectively with other people regardless of differences in cultural backgrounds.
  1. You respect individual differences.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You easily accept new responsibilities.
  1. You are flexible and open to new ideas and encourages others to recognize the value of change.
  1. You can adjust plans and procedures.
  1. You adapt to changes in team membership.
  1. You adapt quickly to new situations.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You analyze interpersonal problems instead of reacting to them.
  1. You step away from a situation to process appropriate response.
  1. You set an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. You use patience and self-control in working with customers and associates.
  1. You are aware of personal impact on others and adjusts behavior to create a positive leadership presence.
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. You are able to understand others' points of view.
  1. You are able to manage your own emotions.
  1. You are able to control your own emotions.
  1. You are attentive to emotional cues and interprets others' feelings correctly.
  1. You accurately perceive the emotions in yourself and others.
Please feel free to provide any comments to help explain your answers?

Achievement

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. I am highly motivated to achieve performance goals.
  1. I was able to increase production by 20 percent.
  1. You set challenging goals.
  1. You take reasonable risks to achieve desired results.
  1. You inspire others to work with a sense of urgency.
Please feel free to provide any comments to help explain your answers?

Objectives

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You assure [Company] principles are understood, employed & pursued.
  1. You set long-term and short-term goals.
  1. You are able to organize work.
  1. You work toward achieving established goals and objectives.
  1. You encourage others to take on greater responsibility.
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. You participate in safety training as applicable.
  1. You seek to reduce the likelihood of accidents.
  1. You mitigate hazards and safety issues that arise.
  1. You are aware of osha safety guidelines.
  1. You create accurate and effective measures of safety.
Please feel free to provide any comments to help explain your answers?

Recognition

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. You reinforce and reward employees for accomplishing necessary goals.
  1. You find opportunities to recognize others.
  1. You compliment other people when they do good work
  1. You make people around them feel appreciated and valued.
  1. You are sincerely interested in the suggestions of co-workers
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.