Trustworthy - 360 Degree Feedback Survey Sample #3





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)
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.

Competencies Included:
Trustworthy, Interpersonal Skills, Adaptability, Creativity, Passion To Learn, Continual Learning, Quality, Initiative, Responsible, Conflict Management, Entrepreneurship
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.




Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Consistently keeps commitments.
  1. Builds and maintains the trust of others.
  1. Takes care to maintain confidential information.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Demonstrates congruence between statements and actions.
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. Is a highly respected individual in the company.
  1. Effectively manages conflicts by dealing with them directly and immediately
  1. Appreciates the extra efforts made by coworkers.
  1. Adapts management style to meet the needs of the individual or situation.
  1. Able to work with individuals at all levels of the Company.
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. Effective in working with different personnel of the team.
  1. Adjusts tactics and strategies.
  1. Is open to changes in policies and procedures.
  1. Is flexible when dealing with changes.
  1. Able to step in and help co-workers when needed.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is creative and inspirational.
  1. Develops solutions to challenging problems.
  1. Conceives, implements and evaluates ideas.
  1. Creates a lot of new ideas.
  1. Inspires creativity in their team.
Please feel free to provide any comments to help explain your answers?

Passion To Learn

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Constantly enhances product knowledge through experimentation and play.
  1. Demonstrates through personal behavior the commitment to high standards of performance.
  1. Enhances value to the company through additional training and development.
  1. Takes initiative for own learning and development.
  1. Is committed to enhancing their own knowledge and skills.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Takes charge of their training and skills enhancement.
  1. Shares best practices with others and learns from others.
  1. Is open to new ideas and concepts.
  1. Pursues learning that will enhance job performance.
  1. Pursues professional development opportunities when they arise.
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. Encourages employees to produce the best quality products.
  1. Reflects on what is working and what could be improved.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Always strives to produce the highest quality work products.
  1. Encourages others to produce the highest quality work products.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Immediately works on solving problems.
  1. Looks for opportunities to move projects forward.
  1. Seizes upon chances to improve the department's prospects.
  1. Is proactive and gets things done.
  1. Initiates projects that have an impact on the department.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is a person you can trust.
  1. ...takes personal responsibility for results.
  1. Acts as a resource without removing individual responsibility.
  1. Responsible for setting the vision of the department.
  1. Holds herself / himself accountable to goals / objectives
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Deals effectively with employee grievances.
  1. Discusses conflict situations with supervisor.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Clearly expresses expectations to others.
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. Excellent at managing relationships with stakeholders.
  1. Balances risks and rewards when making decisions.
  1. Exhibits determination and passion in completion of goals.
  1. Is comfortable operating in an environment of uncertainty.
  1. Able to adapt the department to changing business demands and climate.
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.