HR-Survey > 360-Degree Feedback > Competency Model > Cultural Awareness

Cultural Awareness - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Cultural Awareness:
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)
Survey 14 (4-point scale; N/A)
Instructions:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses, and will be not making any changes, click the Complete button.

Competencies Included:
Cultural Awareness, Leadership, Persuasion and Influence, Administrative Skill, Change Management, Juggling Multiple Responsibilities, Excellence, Responsible, Conflict Management, Strategic Insight, Fiscal Management
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team


Cultural Awareness

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is curious and willing to ask questions about the cultural differences in the workplace.
  1. Willing to work with employees who have different cultural backgrounds.
  1. Understands the impact that our culture may have on interactions between individuals.
  1. Recognizes and values individual and cultural differences.
If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sits down regularly with employees to review their job performance.
  1. Able to influence others.
  1. Expresses clear goals and objectives.
  1. Sets specific, measurable, and challenging goals.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Persuasion and Influence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Attempts to persuade others rather than simply control them.
  1. Ensures stakeholders are involved in the decision making process.
  1. Develops a good rapport with others.
  1. Understanding what others need.
If [Participant Name] were to make improvements in Persuasion and Influence, what are your suggestions for how he/she can improve this?

Administrative Skill

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Has strong technical/computer skills.
  1. High attention to detail.
  1. Implements and uses performance measures.
  1. Takes responsibility for decisions.
If [Participant Name] were to make improvements in Administrative Skill, what are your suggestions for how he/she can improve this?

Change Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Is a leading force driving changes.
  1. Facilitates change with minimal resistance.
  1. Addresses organizational and departmental resistance to changes.
  1. Is an inspiration for others to accept the recent changes.
If [Participant Name] were to make improvements in Change Management, what are your suggestions for how he/she can improve this?

Juggling Multiple Responsibilities

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Ensures that assignments are prioritized according to the needs of the department/company.
  1. Prioritizes tasks for efficiency.
  1. Switches attention to more urgent tasks when necessary.
  1. Determines which tasks are critical and which tasks are optional.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how he/she can improve this?

Excellence

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Produces high quality work.
  1. Demonstrates the analytical skills to do their job.
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Keeps themselves and others focused on constant improvement.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?

Responsible

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Responsible for setting the vision of the department.
  1. Holds herself / himself accountable to goals / objectives
  1. Behavior is ethical and honest.
  1. Sets a good example
If [Participant Name] were to make improvements in Responsible, what are your suggestions for how he/she can improve this?

Conflict Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Facilitates dialog between team members.
  1. Seeks to develop a shared understanding of the issues involved.
  1. Does not let minor issues escalate into major problems.
  1. Persuades others to accept personal transformation.
If [Participant Name] were to make improvements in Conflict Management, what are your suggestions for how he/she can improve this?

Strategic Insight

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Inspires employees to adopt the strategic plan.
  1. Creates a mission statement describing the purpose for the organization.
  1. Works with others to develop insights into the resources and actions required to produce desired results.
  1. Meets with customers to gain insight into their core needs and how best to serve them.
If [Participant Name] were to make improvements in Strategic Insight, what are your suggestions for how he/she can improve this?

Fiscal Management

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Develops of the department's annual budget.
  1. Keeps excellent records for financial transparency.
  1. Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
  1. Ensures others follow the correct rules and regulations on fiscal matters.
If [Participant Name] were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


  3. Please give any final comments or suggestions for [Participant Name Here]'s assessment.