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)
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.

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. Delegates the task of implementing the vision to subordinates.
  1. Translates the department's vision into actionable objectives and a strategic plan.
  1. Ensures that work is systematically aligned and coordinated with the organization's vision.
  1. Effectively communicates the vision to employees.
  1. Demonstrates consistency between words and actions
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
  1. Schedules staff based on seasonal needs.
  1. Is good at planning for the "unexpected".
  1. Is able to follow the plan set in place.
  1. Is able to clearly articulate the plan for the department/district.
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. Creates an environment that supports personal development and exploration.
  1. Exhibits willingness to upgrade skills through additional training and education.
  1. Inspires others to learn new things.
  1. Stays up-to-date on emerging technologies.
  1. Is committed to enhancing their own knowledge and skills.
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
Always
Exhibits this
Competency
  1. Is attentive to emotional cues and interprets others' feelings correctly.
  1. Accurately perceives the emotional reactions of others.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Is able to manage their own emotions.
  1. Able to understand others' points of view.
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
Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. Ensures stakeholders are involved in the decision making process.
  1. Has excellent influencing/negotiating skills.
  1. Seeks to obtain consensus or compromise.
  1. Communicates effectively with others.
  1. Attempts to persuade others rather than simply control them.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is aware of the deadlines for specific tasks/assignments.
  1. Ranks the importance of tasks to make sure critical tasks are completed first.
  1. Determines which tasks are critical and which tasks are optional.
  1. Uses a scheduler/planner to keep tasks organized and on time.
  1. Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
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
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Adopts the implementation of new technology into the workplace.
  1. Understands and is committed to implementing new technologies.
  1. Proficient in the use of technical systems and processes.
  1. Supports employee training and development initiatives regarding implementation of technology.
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. Clearly explains the vision and goals of the company.
  1. Avoids stating unclear or conflicting goals.
  1. Uses appropriate grammar and tense in communications.
  1. Checks details thoroughly.
  1. Communicates ideas and facts clearly and effectively in writing.
Please feel free to provide any comments to help explain your answers?

Trustworthy

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
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Exhibits this
Competency
  1. Is a person you can trust.
  1. Demonstrates a sense of responsibility and commitment to public trust.
  1. Takes ownership, delivers on commitments
  1. Delivers on promises made.
  1. Is trustworthy; is someone I can trust.
Please feel free to provide any comments to help explain your answers?

Customer Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delivers high quality products to the customer.
  1. Is honest in all communication with the customers.
  1. Exceeds expectations of the customers.
  1. Ensures customers' expectations are met or exceeded.
  1. Creates innovative solutions for the 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. Creates opportunities to learn with other team members
  1. Makes sure each team member participates in the task.
  1. Is able to accurately paraphrase and summarize what other team members have said.
  1. Works with other team members on the project.
  1. Promotes a team spirit within and outside department; partners with other groups.
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.