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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
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. Consistently keeps commitments.
  1. Takes care to maintain confidential information.
  1. Is a person you can trust.
  1. Delivers on promises made.
  1. Communicates an understanding of the other person's interests, needs and concerns.
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
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Competency
  1. Follows up on inquiries in a timely manner.
  1. Maintains open and regular communication with others.
  1. Gives good advice and suggestions to coworkers.
  1. Is thoughtful and honest about the feedback they give others.
  1. Gives credit where credit is due.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
  1. Is aware of changes in the environment.
  1. Able to quickly learn new ways of performing their job.
  1. Adjusts strategy when new information is presented.
  1. Responsive to the needs of others.
  1. Adapts to changes in team membership.
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
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Competency
  1. Inspires creativity in their team.
  1. Creates a lot of new ideas.
  1. Conceives, implements and evaluates ideas.
  1. Is creative and inspirational.
  1. Is creative.
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
Sometimes
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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. Exhibits willingness to upgrade skills through additional training and education.
  1. Enjoys learning new skills and techniques.
  1. Stays up-to-date on emerging technologies.
  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
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Competency
  1. Sets relevant learning objectives and goals.
  1. Is open to new ideas and concepts.
  1. Pursues professional development opportunities when they arise.
  1. Pursues learning that will enhance job performance.
  1. Views setbacks as opportunities to learn from.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
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Competency
Seldom
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Competency
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Competency
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  1. Reflects on what is working and what could be improved.
  1. Investigates critical incidents that impact quality.
  1. Is flexible in addressing issues related to quality.
  1. Evaluates and improves the quality of services and products.
  1. Recognizes their role in promoting quality and safety in the workplace.
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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Competency
  1. Capitalizes on opportunities as they become available.
  1. Does things without being told.
  1. Addresses small problems before they become big ones.
  1. Immediately works to complete goals well before their deadline.
  1. Initiates the development of new products.
Please feel free to provide any comments to help explain your answers?

Responsible

Does Not
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Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Acts as a resource without removing individual responsibility.
  1. Sets high personal standards of performance.
  1. Is a person you can trust.
  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

Does Not
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Competency
Seldom
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Competency
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Competency
  1. Encourages team members to express their ideas and concerns openly.
  1. Promotes a culture that values diverse perspectives.
  1. Addresses concerns about the availability of limited resources.
  1. Identifies the root sources of conflict.
  1. Strives to ensure that all basic needs are met, resulting in mutual benefits for both parties.
Please feel free to provide any comments to help explain your answers?

Entrepreneurship

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. Takes the initiative to complete tasks.
  1. Excellent at managing relationships with stakeholders.
  1. Is comfortable operating in an environment of uncertainty.
  1. Encourages risk taking for developing potential business opportunities.
  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.