Level One (Employee's Assessment of a Leader)
Level Two (Leader's Self-Assessment)
Level Three (Manager's Assessment of a Leader)
Level Four (Customer's Assessment of Support Provider)
Level Five (Support Provider's Self-Assessment)
S³® Level One - Employee's Assessment
| "7" if you are Completely Satisfied | "3" if you are Slightly Dissatisfied | |
| "6" if you are Satisfied | "2" if you are Dissatisfied | |
| "5" if you are Slightly Satisfied | "1" if you are Completely Dissatisfied | |
| "4" if you are Neither Satisfied nor Dissatisfied | "N" if you think the Question Does Not Apply |
Ratings for all questions must be provided. Click the "Click Once to Submit Survey" button at the bottom of the page to have your ratings submitted for tabulation.
HOW SATISFIED ARE YOU ...?
A. COMMUNICATION DIMENSION |
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| 1. | ...That you are free to discuss your job with your leader? | |
| 2. | ...With the frequency your leader asks you for your ideas and suggestions on solving job problems? | |
| 3. | ...That you can privately, but candidly, question your leader’s suggestions, requirements and communications? | |
| 4. | ...That you can contact your leader when necessary? | |
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| 5. | ...With the frequency your leader uses your ideas and suggestions? | |
| 6. | ...That your leader has confidence in you and your decisions? | |
| 7. | ...That your leader supports your decisions? | |
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| 8. | ...That your leader knows or can help develop the solutions to most of your job or task problems? | |
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| 9. | ...That your leader provides sufficient assistance, equipment, training, and resources to allow you to successfully perform your job? | |
| 10. | ...That your leader responds to your requests quickly? | |
| 11. | ...With the frequency your leader offers you assistance or help? | |
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| 12. | ...With the frequency your leader compliments you on your job performance? | |
| 13. | ...With the pleasantness of your leader? | |
| 14. | ...That the other staff of your leader are pleasant? | |
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| 15. | ...That your leader provides the information you need to improve your job performance? | |
| 16. | ...That the performance information provided to you by your leader is used to help you rather than used punitively? | |
| 17. | ...That your leader helps you understand the purpose of your job and work tasks as they relate to the organization’s mission? | |
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| 18. | ...That your leader allows you sufficient independence in making decisions concerning your job? | |
| 19. | ...That after considering other points of view your leader makes firm and lasting decisions? | |
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| 20. | ...That your leader is sensitive to diversity and differences among people? | |
| 21. | ...That your leader is family sensitive? | |
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| 22. | ...That you are happy working in this leader's unit? | |
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S³® Level Two - Self Assessment
| Name of Manager/Supervisor being rated |
Company |
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| Division |
Unit |
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| "7" if you are Completely Satisfied | "3" if you are Slightly Dissatisfied | |
| "6" if you are Satisfied | "2" if you are Dissatisfied | |
| "5" if you are Slightly Satisfied | "1" if you are Completely Dissatisfied | |
| "4" if you are Neither Satisfied nor Dissatisfied | "N" if you think the Question Does Not Apply |
Ratings for all questions must be provided. Click the "Click Once to Submit Survey" button at the bottom of the page to have your ratings submitted for tabulation.
HOW SATISFIED ARE YOU ...?
A. COMMUNICATION DIMENSION |
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| 1. | ...That your staff are free to discuss their job with you? | |
| 2. | ...With the frequency you ask your staff for their ideas and suggestions on solving job problems? | |
| 3. | ...That your staff can privately, but candidly, question your suggestions, requirements, and communications? | |
| 4. | ...That your staff can contact you when necessary? | |
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| 5. | ...With the frequency you use your staff’s ideas and suggestions? | |
| 6. | ...That you have confidence in your staff and their decisions? | |
| 7. | ...That you support your staff’s decisions? | |
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| 8. | ...That you know or can help your staff develop the solutions to most of their job or task problems? | |
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| 9. | ...That you provide sufficient assistance, equipment, training, and resources to allow your staff to successfully perform their job? | |
| 10. | ...That you respond to your staff’s requests quickly? | |
| 11. | ...With the frequency you offer your staff assistance or help? | |
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| 12. | ...With the frequency you compliment your staff on their job performance? | |
| 13. | ...That you are pleasant? | |
| 14. | ...That the other staff in the unit supervised by you are pleasant? | |
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| 15. | ...That you provide the information your staff needs to improve their job performance? | |
| 16. | ...That the performance information provided by you is used to help your staff rather than used punitively? | |
| 17. | ...That you help your staff understand the purpose of their job and work tasks as they relate to the organization’s mission? | |
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| 18. | ...That you allow your staff sufficient independence in making decisions concerning their job? | |
| 19. | ...That after considering other points of view, you make firm and lasting decisions? | |
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| 20. | ...That you are sensitive to diversity and difference among people? | |
| 21. | ...That you are family sensitive? | |
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| 22. | ...That your staff are happy working in your unit? | |
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S³® Level Three - Manager's Assessment
| Name of Leader being rated |
Company |
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| Division |
Unit |
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| "7" if you are Completely Satisfied | "3" if you are Slightly Dissatisfied | |
| "6" if you are Satisfied | "2" if you are Dissatisfied | |
| "5" if you are Slightly Satisfied | "1" if you are Completely Dissatisfied | |
| "4" if you are Neither Satisfied nor Dissatisfied | "N" if you think the Question Does Not Apply |
Ratings for all questions must be provided. Click the "Click Once to Submit Survey" button at the bottom of the page to have your ratings submitted for tabulation.
HOW SATISFIED ARE YOU ...?
A. COMMUNICATION DIMENSION |
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| 1. | ...That the staff of this leader are free to discuss their jobs with their leader? | |
| 2. | ...With the frequency this leader asks his/her staff for their ideas and suggestions in solving job problems? | |
| 3. | ...That the staff of this leader can privately, but candidly, question their leader’s suggestions, requirements, and communications? | |
| 4. | ...That the staff can contact their leader when necessary? | |
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| 5. | ...With the frequency this leader uses his/her staff’s ideas and suggestions? | |
| 6. | ...That this leader has confidence in his/her staff and their decisions? | |
| 7. | ...That this leader supports the decisions of his/her staff? | |
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| 8. | ...That this leader knows or can help develop the solutions to most of his/her staff’s job or task problems? | |
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| 9. | ...That this leader provides sufficient assistance, equipment, training, and resources to allow his/ her staff to successfully perform their jobs? | |
| 10. | ...That this leader responds to his/her staff’s requests quickly? | |
| 11. | ...With the frequency this leader offers assistance or help to his/her staff? | |
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| 12. | ...With the frequency this leader compliments her/his staff on their job performances? | |
| 13. | ...That this leader is pleasant with his/her staff? | |
| 14. | ...That the staff of this leader are pleasant? | |
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| 15. | ...That this leader provides the information her/his staff need to improve their job performance? | |
| 16. | ...That the performance information provided by this leader to his/her staff is used to help them rather than used punitively? | |
| 17. | ...That this leader helps her/his staff understand the purpose of their jobs and work tasks as they relate to the organization’s mission? | |
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| 18. | ...That this leader allows his/her staff sufficient independence in making decisions concerning their jobs? | |
| 19. | ...That after considering other points of view this leader makes firm and lasting decisions? | |
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| 20. | ...That this leader is sensitive to diversity and differences among people? | |
| 21. | ...That this leader is family sensitive? | |
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| 22. | ...That this leader’s staff are happy working in her/his unit? | |
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S³® Level Four - Customer's Assessment of Support Provider
| Name of Support Provider being rated |
Company |
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| Division |
Unit |
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| "7" if you are Completely Satisfied | "3" if you are Slightly Dissatisfied | |
| "6" if you are Satisfied | "2" if you are Dissatisfied | |
| "5" if you are Slightly Satisfied | "1" if you are Completely Dissatisfied | |
| "4" if you are Neither Satisfied nor Dissatisfied | "N" if you think the Question Does Not Apply |
Ratings for all questions must be provided. Click the "Click Once to Submit Survey" button at the bottom of the page to have your ratings submitted for tabulation.
HOW SATISFIED ARE YOU ...?
A. COMMUNICATION DIMENSION |
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| 3. | ...That you can privately, but candidly, question this individual's suggestions, requirements and communications? | |
| 4. | ...That you can contact this individual when necessary? | |
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| 10. | ...That this individual responds to your requests quickly? | |
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| 13. | ...With the pleasantness of this individual? | |
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| 15. | ...That this individual provides the information you need? | |
| 17. | ...That this individual helps you understand the purpose of their suggestions, requirements and communications? | |
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| 20. | ...That this individual is sensitive to diversity and differences among people? | |
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S³® Level Five - Support Provider's Self Assessment
| Name of Support Provider being rated |
Company |
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| Division |
Unit |
| "7" if you are Completely Satisfied | "3" if you are Slightly Dissatisfied | |
| "6" if you are Satisfied | "2" if you are Dissatisfied | |
| "5" if you are Slightly Satisfied | "1" if you are Completely Dissatisfied | |
| "4" if you are Neither Satisfied nor Dissatisfied | "N" if you think the Question Does Not Apply |
Ratings for all questions must be provided. Click the "Click Once to Submit Survey" button at the bottom of the page to have your ratings submitted for tabulation.
HOW SATISFIED ARE YOU ...?
A. COMMUNICATION DIMENSION |
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| 3. | ...That your customers can privately, but candidly, question your suggestions, requirements, and communications? | |
| 4. | ...That your customers can contact you when necessary? | |
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| 10. | ...That you respond to your customers’ requests quickly? | |
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| 13. | ...That you are pleasant with your customers? | |
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| 15. | ...That you provide the information your customers' need? | |
| 17. | ...That you help your customers understand the purpose of your suggestions, requirements, and communications? | |
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| 20. | ...That you are sensitive to diversity and difference among people? | |
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Rev: 07/23/10
