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Trustworthy - 360 Degree Feedback Survey Sample #3





Questionnaires Measuring Trustworthy:
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)
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.



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Trustworthy

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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  1. Is a person you can trust.
  1. Delivers on promises made.
  1. Seeks to mitigate grievances by clarifying intentions and finding suitable remedies.
  1. Takes ownership, delivers on commitments
  1. Demonstrates a sense of responsibility and commitment to public trust.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
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Competency
Seldom
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Competency
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  1. Embraces the differences in individuals that comprise the team.
  1. Able to work with individuals at all levels of the Company.
  1. Assists those in the department who need help in meeting performance metrics.
  1. Is open and approachable
  1. Uses tact, compassion, and sensitivity in interactions with others.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
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  1. Adjusts priorities to changing business goals.
  1. Adjusts plans to meet new situations.
  1. Able to adjust to changes as needed.
  1. Adjusts plans and procedures.
  1. Learns new ways to perform tasks; adopts new skill sets as required.
Please feel free to provide any comments to help explain your answers?

Creativity

Does Not
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  1. Is willing to enlist others to help create new solutions to existing problems.
  1. Facilitates creative exchange across organizational boundaries.
  1. Uses tension as a catalyst for creative progress.
  1. Creates imaginative prompts to inspire the team's idea generation.
  1. Consistently brings fresh, unconventional ideas to the table.
Please feel free to provide any comments to help explain your answers?

Passion To Learn

Does Not
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Competency
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Competency
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  1. Demonstrates through personal behavior the commitment to high standards of performance.
  1. Enhances value to the company through additional training and development.
  1. Will participate in training classes even if offered outside of normal working hours.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Constantly enhances product knowledge through experimentation and play.
Please feel free to provide any comments to help explain your answers?

Continual Learning

Does Not
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  1. Pursues professional development opportunities when they arise.
  1. Participates in regular training offered.
  1. Pursues self-improvement through continual learning.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Shares best practices with others and learns from others.
Please feel free to provide any comments to help explain your answers?

Quality

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  1. Competently and accurately analyzes quality measures.
  1. Recognizes their role in promoting quality and safety in the workplace.
  1. Designs effective quality control systems.
  1. Mitigates quality issues before they impact production lines.
  1. Holds employees accountable for their quality of work.
Please feel free to provide any comments to help explain your answers?

Initiative

Does Not
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  1. Empowers team members to quickly take ownership of problems and propose impactful solutions.
  1. Takes the initiative to complete tasks ahead of schedule.
  1. Takes action in the absence of specific direction.
  1. Addresses small problems before they become big ones.
  1. Takes on extra projects after required work is completed.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
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  1. Acts as a resource without removing individual responsibility.
  1. ...takes personal responsibility for results.
  1. Sets high personal standards of performance.
  1. Behavior is ethical and honest.
  1. Holds herself / himself accountable to goals / objectives
Please feel free to provide any comments to help explain your answers?

Conflict Management

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  1. Determines what issues can be agreed upon.
  1. Uses conflict as a springboard for leadership development, helping individuals grow in resilience, empathy, and influence.
  1. Creates an environment where concerns can be voiced early, making it easier to address issues before they escalate.
  1. Sees conflicts as chances to develop innovative and effective solutions.
  1. Anticipates where bottlenecks or competing priorities may cause tension and adjusts systems accordingly.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
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Competency
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Competency
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Competency
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  1. Able to adapt the department to changing business demands and climate.
  1. Has a strategic awareness on how to promote the organization.
  1. Is comfortable operating in an environment of uncertainty.
  1. Takes the initiative to complete tasks.
  1. Can work effectively in an environment of uncertainty.
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.