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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; floating anchors)
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
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Cultural Awareness

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Accepts individual differences.
  1. Publicly acknowledges cultural contributions and achievements in team settings.
  1. Tailors solutions to accommodate diverse cultural needs and expectations.
  1. Is willing to include individuals with different cultural backgrounds on the team.
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. Expects every team member to contribute ideas during discussions and decision-making.
  1. Sits down regularly with employees to review their job performance.
  1. Credits subordinates for good performance.
  1. Encourages ownership of results and expects employees to take responsibility for outcomes.
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. Uses clear examples and measurable results to support arguments, making complex issues more tangible.
  1. Identifies cultural, political, or organizational sensitivities before making a case, avoiding missteps that could undercut credibility.
  1. Uses compelling analogies and metaphors to make abstract goals tangible and relatable.
  1. Gives examples of personal experiences to employees to help persuade them of the correct course of action.
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. Plans and prioritizes facets/aspects of project workloads to keep on schedule.
  1. Maintains a clear and positive tone when speaking avoiding mumbling or use of slang terms.
  1. Uses automated and manual records management systems.
  1. Enthusiastic about taking on challenging projects.
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. Succinctly conveys a vision of the changes in a way that is easy for employees to understand.
  1. Conducts a market competitive analysis to determine where the organization may need to change to better meet the needs of the marketplace.
  1. Offers training, resources, and encouragement to help employees adapt and succeed in the new environment.
  1. Effective in implementing new organizational vision and values.
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. Determines which tasks are critical and which tasks are optional.
  1. Recognizes and responds to product placement and signing needs while staying alert to customers' needs, store activities and training associates.
  1. Ensures that assignments are prioritized according to the needs of the department/company.
  1. Uses a scheduler/planner to keep tasks organized and on time.
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. 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.
  1. Is planful and organized.
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. Completes assigned work tasks.
  1. Sets a good example
  1. Acts as a resource without removing individual responsibility.
  1. Holds herself / himself accountable to goals / objectives
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. Explores the feasibility of alternative solutions to resolve conflicts.
  1. Navigates emotionally charged situations with tact, persuading others to consider alternative viewpoints without defensiveness.
  1. Identifies patterns in recurring conflicts, using historical data or behavioral trends to inform resolution strategies.
  1. Listens to individuals as they offer their unique perspectives on the situation.
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. Adjusts strategic plans based on insights gathered from different points of view.
  1. Translates complex industry trends into actionable strategies for the team/department.
  1. Creates a mission statement describing the purpose for the organization.
  1. Attends industry conferences to gain further insight into how other companies deal with similar issues.
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. Keeps excellent records for financial transparency.
  1. Develops budgets and plans for various programs and initiatives.
  1. Develops of the department's annual budget.
  1. Monitors expenses and verifies the need for items purchased.
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.