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HR-Survey > 360-Degree Feedback > Competency Model > Recognition
Recognition- 360 Degree Feedback Survey Sample #3
October 31, 2025
Surveys Measuring Recognition: Competencies Included:
Survey 1 (4-point scale; Competency Comments) Recognition, Bias for Action, Emotional Intelligence,
Survey 2 (4-point scale; Competency Comments) Delegation, Change Management, Managing Risk, Safety,
Survey 3 (5-point scale; Competency Comments) Interpersonal Skills, Global Perspective
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.
We encourage everyone to complete the survey. Please be honest,
constructive and thoughtful in your input. The survey is designed to Sample Result Document:
help us understand more about your thoughts and needs to make Sample Results
this a great company.
Please ensure that your submission is made between November 1 and November 14. The survey will only be available during
these dates.
Recognition Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
1. Consistently applying standards across the team
ensuring that recognition is equitable and meaningful
to everyone.
2. Offers recognition for big accomplishments.
3. Uses recognition to guide employees to better work
standards.
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4. Accompanies recognition with specific examples of
how the employee's work made a difference for the
department/organization.
5. Uses recognition and rewards to reinforce desired
behaviors.
Please feel free to provide any comments to help explain your answers?
Bias for Action Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
6. Makes decisions within a specific time limit to avoid
overthinking about problems.
7. Gets the team to initially complete small tasks to boost
their confidence and motivation to take on bigger
challenges.
8. Assists others to ensure that everyone is on track to
help the team reach its goals faster.
9. Makes the most of the available resources, whether it's
time, equipment, or people.
10. Adapts to changing circumstances and finds new ways
to achieve goals.
Please feel free to provide any comments to help explain your answers?
Emotional Intelligence Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
11. Is able to manage their own emotions.
12. Is able to express themselves clearly.
13. Is attentive to emotional cues and interprets others'
feelings correctly.
14. Is able to control their own emotions.
15. Helps to make decisions and solve problems using
knowledge about how others will react in certain
situations.
Please feel free to provide any comments to help explain your answers?
Delegation Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
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Email: info@[Link]
Competency Competency Competency Competency
16. Gives the employees the freedom to approach tasks
with their own skills and judgment, fostering creativity
and problem-solving.
17. Secures employee agreement on the delegated
responsibility.
18. Evaluates employees' proficiency in various
competencies to align tasks with their expertise.
19. Selects appropriate individuals to complete tasks.
20. Reviews workload distribution to avoid duplication or
gaps in accountability.
Please feel free to provide any comments to help explain your answers?
Change Management Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
21. Solicits input from employees to help get their buy-in
for the change.
22. Is interested in working on projects that may not be
well defined.
23. Determines the appropriate changes needed.
24. Monitors and assesses the changes.
25. Tailors leadership methods to fit shifting business
needs.
Please feel free to provide any comments to help explain your answers?
Managing Risk Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
26. Accurately determines appropriate risk levels (i.e., levels
of acceptable risk).
27. Understands how to meet regulatory compliance.
28. Monitors enterprise risk management activities for
their impact and effectiveness on mitigating risks.
29. Tracks and monitors incidents that may increase the
risk of adverse consequences.
30. Adopts a risk-based approach to establishing systems
of internal controls.
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Please feel free to provide any comments to help explain your answers?
Safety Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
31. Encourages others to work safely.
32. Performs work safely.
33. Is aware of OSHA safety guidelines.
34. Is not afraid to question a potential safety issue
observed in the workplace.
35. Ensures compliance with safety regulations.
Please feel free to provide any comments to help explain your answers?
Interpersonal Skills Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
36. Is someone you can trust.
37. Offers praise to colleagues who have successfully
completed major projects.
38. Keeps commitments made with coworkers.
39. Easily approachable.
40. Works diligently to assist customers in finding the right
products.
Please feel free to provide any comments to help explain your answers?
Global Perspective Does Not Seldom Sometimes Usually Always
Exhibit this Exhibits this Exhibits this Exhibits this Exhibits this
Competency Competency Competency Competency Competency
41. Understands how cultures differ and how these
differences impact work behavior.
42. Is able to work with individuals having different
backgrounds and cultures.
43. Respects individual differences.
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44. Able to listen and understand others and discuss issues
in a respectful way.
45. Analyzes global issues/problems that are having a
large impact on the Company.
Please feel free to provide any comments to help explain your answers?
46. Overall, please rate the effectiveness of [Participant Name].
5- Very Effective
4- Effective
3- Neither
2- Ineffective
1- Very Ineffective
47. Strengths
48. Areas for Development
49. Please give any final comments or suggestions for [Participant Name Here]'s assessment.
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