Trustworthy - 360 Degree Feedback Survey Sample #2





Questionnaires Measuring Trustworthiness:
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

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. Feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences as an employee over the last twelve months and the goals you were asked to achieve. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Trustworthy, Communication Skills, Professional Development, Persuasion and Influence, Innovation, Change Management, Clarity, Client Focus, Co-worker Development, Fiscal Management, Vision
Sample Result Document:
Sample Results
Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

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


Trustworthy

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You take ownership, deliver on commitments
  1. You seek to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. You take care to maintain confidential information.
  1. You demonstrate a sense of responsibility and commitment to public trust.
  1. You build and maintain the trust of others.
What are your suggestions for how you can make improvements
in Trustworthy?

Communication Skills

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I transform complicated ideas into simple ones.
  1. I listen effectively and respond to new information.
  1. I articulate ideas and emotions clearly to others.
  1. You overcome barriers that prevent effective communication.
  1. You deliver effective public presentations.
What are your suggestions for how you can make improvements
in Communication Skills?

Professional Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You keep yourself up-to-date of technical/professional issues
  1. You allow employees to fully participate in employee training and professional development.
  1. You are contributing fully to the extent of your skills
  1. You seek opportunities for continuous learning.
  1. You seek opportunities for professional development.
What are your suggestions for how you can make improvements
in Professional Development?

Persuasion and Influence

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You attempt to persuade others rather than simply control them.
  1. You are able to express own goals and needs.
  1. You persuade others to consider alternative points of view.
  1. You develop a good rapport with others.
  1. You have excellent influencing/negotiating skills.
What are your suggestions for how you can make improvements
in Persuasion and Influence?

Innovation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You suggest new ideas at meetings.
  1. You find creative ways to get things done with limited resources.
  1. You offer constructive improvements to existing systems.
  1. You solve problems with insight and understanding.
  1. You analyze current procedures and identify opportunities for improvement.
What are your suggestions for how you can make improvements
in Innovation?

Change Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I develop plans for following through on the changes.
  1. You are effective in implementing new organizational vision and values.
  1. You support the Company's efforts to implement changes.
  1. I inspire others to accept the recent changes.
  1. You are effective in dealing with ambiguous and challenging situations.
What are your suggestions for how you can make improvements
in Change Management?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You avoid stating unclear or conflicting goals.
  1. You are clear about goals that need to be achieved.
  1. You make sure employees understand why they were given certain assignments.
  1. You seek to reduce ambiguity in messaging and documents.
  1. You attend to the important details of a job or task.
What are your suggestions for how you can make improvements
in Clarity?

Client Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. I provide a responsive service that meets the needs of clients.
  1. I meet with clients on a regular basis.
  1. You are pro-active in dealing with clients and addressing your needs.
  1. You focus on the unique needs of each client.
  1. I ensure that commitments made to clients are completed to the client's satisfaction.
What are your suggestions for how you can make improvements
in Client Focus?

Co-worker Development

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You take immediate action on poor performance
  1. You give others development opportunities through project assignments and increased job responsibilities
  1. You set and clearly communicate expectations, performance goals, and measurements to others
  1. You work to identify root causes of performance problems
  1. You provide ongoing feedback to co-workers on your development progress
What are your suggestions for how you can make improvements
in Co-worker Development?

Fiscal Management

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You keep excellent records for financial transparency.
  1. You develop of the department's annual budget.
  1. You develop budgets and plans for various programs and initiatives.
  1. You monitor expenses and verify the need for items purchased.
  1. You provide budgeting and accounting support to the Company.
What are your suggestions for how you can make improvements
in Fiscal Management?

Vision

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You formulate strategies that reflect a shared vision for the organization.
  1. You ensure that work is systematically aligned and coordinated with the organization's vision.
  1. You cultivate an environment that embodies the department's vision.
  1. I create a compelling vision inspires employees, giving them a sense of purpose and direction.
  1. I establish the direction and strategy for the organization.
What are your suggestions for how you can make improvements
in Vision?


  1. Strengths


  2. Areas for Development


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.