Org AI Baseline Survey Builder

You are designing an AI capability baseline for the following organization:

Company:
Industry:
Regulatory constraints:
Teams in scope:
Existing AI tools:
Known adoption gaps:
Current AI initiatives:
Target date:

Use this three-level model:

• L1 Basic: can use chat interfaces for asking, drafting, editing, summarizing, light research, and verification.
• L2 Intermediate: can delegate multi-step work with files, connectors, context, and review checkpoints.
• L3 Builder: can package reusable workflows, prompts, skills, automations, or internal tools for a department.

Create a rigorous but lightweight baseline instrument with:

1. A 10-question self-assessment.
2. A manager calibration rubric.
3. Observable evidence required for each level.
4. A department-level rollup format.
5. Suggested target levels by role segment.
6. Questions that surface motivation, blockers, and risk concerns.
7. A scoring method that avoids over-crediting casual AI usage.

Keep the instrument practical enough to run in one week. Avoid LMS language. Output in a format I can paste into a doc.