Cultural Awareness - 360 Degree Feedback Survey Sample #1

Instructions:

The 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.

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 and . 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
Fosters a diverse workforce free from discrimination and harassment.
Respects others regardless of age, race, gender, nationality, or disability.
Recognizes and values individual and cultural differences.
Seeks out different viewpoints and benefits from different perspectives.
Encourages a work environment where individual differences are valued.
If 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
Gives direct, constructive, and actionable feedback.
Takes ownership and accountability for results
Demonstrates leadership and courage in critical situations.
Effectively leads others.
Highly effective supervisor.
If 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
Develops a good rapport with others.
Persuades others to consider alternative points of view.
Communicates effectively with others.
Attempts to persuade others rather than simply control them.
Seeks to obtain consensus or compromise.
If 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
Enthusiastic about taking on challenging projects.
High attention to detail.
Has strong technical/computer skills.
Able to develop, justify and present a budget.
Strong organizational skills to keep the workspace and department in order
If 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
Supports new initiatives for organizational changes to improve effectiveness.
Adopts changes to set and example for others to follow.
Works cooperatively with others to implement changes.
Effective in dealing with ambiguous and challenging situations.
Effective in implementing new organizational vision and values.
If 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
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Can multi-task while performing all of their other responsibilities and activities.
Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
Bounces back from daily crisis, disappointments and frustrations.
Manages impact of increased traffic flow and freight receipt by detailed planning of controllables and by anticipating and reacting positively to uncontrollables.
If 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
Is planful and organized.
Demonstrates the functional or technical skills necessary to do their job.
Produces high quality work.
Takes a lot of pride in their work.
Can be counted on to add value wherever they are involved.
If 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
Sets high personal standards of performance.
...takes personal responsibility for results.
Holds herself / himself accountable to goals / objectives
Acts as a resource without removing individual responsibility.
Sets a good example.
If 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
Assists team members by helping them see the other point of view.
Identifies and takes steps to prevent potential confrontations.
Helps employees to think through alternative ways to resolve conflict situations.
Discusses conflict situations with supervisor.
Tries to understand others' point of view before making judgments
If 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
Maintains knowledge of current trends in the industry.
Analyzes unique issues or problems impacting the Company.
Implements long-term solutions to problems.
Identifies root causes of problems.
Anticipates business cycles and trends and makes adjustments in a timely manner.
If 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
Develops budgets and plans for various programs and initiatives.
Develops of the department's annual budget.
Effectively manages appropriations, reporting, purchases, expenditures, payrolls, and staff.
Monitors expenses and verifies the need for items purchased.
Ensures others follow the correct rules and regulations on fiscal matters.
If were to make improvements in Fiscal Management, what are your suggestions for how he/she can improve this?

56. What are 's greatest strengths demonstrated this year?
    
    
    
57. What are 's areas for development?
    
    
    
58. Please give any final comments or suggestions for 's assessment.