Vision- 360 Degree Feedback Survey Sample #3





Surveys Measuring Vision:
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.

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.





Vision

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Understands the vision of the Company and promotes it ahead of any self-interests.
  1. Expresses the Company vision in a way that is easily understood and adopted by employees.
  1. Demonstrates consistency between words and actions
  1. Communicates the vision and strategy of [Company]
  1. Develops action plans to align his/her work with the goals of the organization
Please feel free to provide any comments to help explain your answers?

Planning

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Competency
  1. Is able to clearly articulate the plan for the department/district.
  1. Efficiently manages deadlines.
  1. Reorders the schedule of events to maximize attendance/efficiency.
  1. Adjusts and rearranges the schedule to maximize efficiency.
  1. Determines the allocation of funds based on plans for future development.
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. Takes advantage of training opportunities when they arise.
  1. Embraces new technology and procedures.
  1. Is committed to enhancing their own knowledge and skills.
  1. Demonstrates a willingness to participate in continuing education courses.
  1. Enjoys learning new skills and techniques.
Please feel free to provide any comments to help explain your answers?

Emotional Intelligence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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Competency
  1. Is able to manage their own emotions.
  1. Is able to control their own emotions.
  1. Able to understand others' points of view.
  1. Is able to express themselves clearly.
  1. Is attentive to emotional cues and interprets others' feelings correctly.
Please feel free to provide any comments to help explain your answers?

Persuasion and Influence

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. Has excellent influencing/negotiating skills.
  1. Attempts to persuade others rather than simply control them.
  1. Able to express own goals and needs.
  1. Understanding what others need.
  1. Seeks to obtain consensus or compromise.
Please feel free to provide any comments to help explain your answers?

Juggling Multiple Responsibilities

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
Always
Exhibits this
Competency
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Plans and organizes continuously while performing all other responsibilities and activities.
  1. Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
  1. Switches attention to more urgent tasks when necessary.
Please feel free to provide any comments to help explain your answers?

Technology Use/Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
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Competency
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Competency
  1. Proficient in the use of technical systems and processes.
  1. Supports technical training and development of employees.
  1. Understands and is committed to implementing new technologies.
  1. Uses technology in decision making and problem solving.
  1. Applies complex rules and regulations to maintain optimal system performance.
Please feel free to provide any comments to help explain your answers?

Clarity

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Clarifies problems and their causes to help employees correct them.
  1. Avoids stating unclear or conflicting goals.
  1. Avoids creating ambiguity or mixed messages.
  1. Clearly explains the vision and goals of the company.
  1. Communicates with clarity and efficiency.
Please feel free to provide any comments to help explain your answers?

Trustworthy

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 ownership, delivers on commitments
  1. Is a person you can trust.
  1. Delivers on promises made.
  1. Consistently keeps commitments.
  1. Works in a way that makes others want to work with her/him.
Please feel free to provide any comments to help explain your answers?

Customer Focus

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. Is committed to the success of the customer.
  1. Keeps the customer informed of all progress.
  1. Accepts responsibility for ensuring customer satisfaction.
  1. Prioritizes the needs and preferences of the customer.
  1. Maintains strong relationships with customers.
Please feel free to provide any comments to help explain your answers?

Teamwork

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Works with other team members to identify bottle necks in the production process.
  1. Comes across as a reliable, committed team member
  1. Facilitates good rapport between team members.
  1. Applies knowledge of team behavior to help achieve organizational goals and objectives.
  1. Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
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.