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
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Competency
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Exhibits this
Competency
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Delivers on promises made.
  1. Is trustworthy; is someone I can trust.
  1. Is a person you can trust.
  1. Consistently keeps commitments.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
Usually
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Competency
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Competency
  1. Communicates well at all levels of the organization.
  1. Assists those in the department who need help in meeting performance metrics.
  1. A good listener who is attentive to others.
  1. Demonstrates willingness to work with others.
  1. Assists employees that need help.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Is aware of changes in the environment.
  1. Able to respond to incidents without stopping the workflow.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Flexible and open to new ideas and encourages others to recognize the value of change.
  1. Develops insights and applies innovative solutions to projects and problems.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
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Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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  1. Is creative and inspirational.
  1. Conceives, implements and evaluates ideas.
  1. Adds value to the department/organization.
  1. Is creative.
  1. Creates a lot of new ideas.
Please feel free to provide any comments to help explain your answers?

Passion To Learn

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
  1. Takes advantage of training opportunities when they arise.
  1. Is committed to enhancing their own knowledge and skills.
  1. Inspires others to learn new things.
  1. Demonstrates a willingness to participate in continuing education courses.
  1. Holds self and associates accountable for goal achievement.
Please feel free to provide any comments to help explain your answers?

Continual Learning

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
  1. Shares best practices with others and learns from others.
  1. Sets relevant learning objectives and goals.
  1. Is open to new ideas and concepts.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Improves on their skill sets.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
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Competency
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Competency
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  1. Develops processes to enhance quality standards.
  1. Effectively coordinates with other departments to improve quality.
  1. Ensures high consistency across batches or production runs.
  1. Is flexible in addressing issues related to quality.
  1. Communicates quality standards that are easily by employees.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Prepares for unexpected contingencies.
  1. Initiates projects that have an impact on the department.
  1. Cleans the workspace without being told.
  1. Seizes upon opportunities available.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
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Competency
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  1. Completes assigned work tasks.
  1. Sets high personal standards of performance.
  1. Acts as a resource without removing individual responsibility.
  1. Sets a good example.
  1. Sets a good example
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
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Competency
Seldom
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  1. Is responsive to contentious issues.
  1. Prevents minor issues from escalating into major problems.
  1. Prepares team members to accept differing view points.
  1. Works to settle conflicts in a manner that is acceptable for a long-term solution.
  1. Listens to individuals as they offer their unique perspectives on the situation.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Excellent at managing relationships with stakeholders.
  1. Is comfortable operating in an environment of uncertainty.
  1. Encourages dynamic growth opportunities.
  1. Able to adapt the department to changing business demands and climate.
  1. Balances risks and rewards when making decisions.
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.