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Cultural Awareness - 360 Degree Feedback Survey Sample #2





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)
Self-Assessment Instructions

You have been asked to complete a self-assessment questionnaire form (shown below). You will also receive feedback from others such as your peers, direct reports and manager. 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 as an employee over the last twelve months and the goals you were asked to achieve. 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 become part of the assessment process to foster your growth and on-going development.

Competencies Included:
Cultural Awareness, Managing Performance, Creativity, Feedback, Attitude, Decision Making, Innovation, Achievement, Clarity, Customer Focus, Recognition, Business Acumen
Sample Result Document:
Sample Results
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.

Please ensure that your submission is made between . The survey will only be available during these dates.
Edit this Survey
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Cultural Awareness

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You understand how your own cultural background can impact the way you communicate and interact with others.
  1. You avoid referring to stereotypes about others from different cultures.
  1. I am aware of cultural differences in business etiquette.
  1. I develop skills and attitudes to bridge cultural differences.
  1. You value the opinions of diverse groups and individual.
What are your suggestions for how you can make improvements
in Cultural Awareness?

Managing Performance

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You routinely hold audits of performance on a weekly or monthly basis.
  1. I communicate the roles and responsibilities to the employee.
  1. You effectively use the current performance review process.
  1. You initiate a performance improvement plan for underperforming subordinates.
  1. You reward employees for exceeding goals.
What are your suggestions for how you can make improvements
in Managing Performance?

Creativity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You create a lot of new ideas.
  1. You are creative and inspirational.
  1. You are creative.
  1. You develop solutions to challenging problems.
  1. You inspire creativity in your team.
What are your suggestions for how you can make improvements
in Creativity?

Feedback

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You look to others for input.
  1. You are open to the suggestions of others.
  1. You consider other's opinion and suggestions.
  1. You are easy to approach with ideas and opinions.
  1. You ask others for their ideas and opinions.
What are your suggestions for how you can make improvements
in Feedback?

Attitude

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You contribute to a positive and fun work environment.
  1. You are gracious and professional in your interactions with others.
  1. You work to eliminate unnecessary work or barriers that get in others' way.
  1. You contribute to a positive work environment.
  1. You build open and trusting relationships.
What are your suggestions for how you can make improvements
in Attitude?

Decision Making

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are open to the suggestions from subordinates.
  1. You come across as confident, decisive, and resilient
  1. You view the long and short-term impact of decisions.
  1. I am receptive to new ideas from others when making decisions.
  1. I regularly evaluate information before making important decisions.
What are your suggestions for how you can make improvements
in Decision Making?

Innovation

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You develop effective solutions for viewing problems from a different point of view.
  1. You help focus the department on innovation.
  1. You improve on ideas of others.
  1. You improve and makes systems more efficient.
  1. You guarantee that team members are equipped with the technical expertise needed to excel in innovative projects.
What are your suggestions for how you can make improvements
in Innovation?

Achievement

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You set challenging goals.
  1. You complete work to given time frame and to budget
  1. You allocate resources as needed to accomplish organizational goals.
  1. You are driven to complete assignments on time.
  1. You systematically work to improve the organization
What are your suggestions for how you can make improvements
in Achievement?

Clarity

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You use appropriate grammar and tense in communications.
  1. You clearly define work objectives for employees.
  1. You are clear about goals that need to be achieved.
  1. You clearly explain the vision and goals of the company.
  1. You maintain clarity in goals and objectives.
What are your suggestions for how you can make improvements
in Clarity?

Customer Focus

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You address customer complaints immediately.
  1. You provide excellent service to customers.
  1. You follow up with any unanswered questions from the customer.
  1. I tailor solutions to meet the specific needs of each customer.
  1. You look for opportunities that have a positive impact on customers.
What are your suggestions for how you can make improvements
in Customer Focus?

Recognition

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You recognize team members who offer a significant contribution to a project.
  1. You make people around them feel appreciated and valued.
  1. You say "thank you" to show appreciation for work of others.
  1. You recognize the abilities and skills of self and others
  1. You recognize individuals for a specific outstanding achievement.
What are your suggestions for how you can make improvements
in Recognition?

Business Acumen

Clear
Strength
Capable
and
Effective
Could
Benefit from
Development
Needs
Significant
Improvement
  1. You are able to align resources to meet the business needs of the company.
  1. I seek to better understand other areas of the company, including their operations, personnel, and output.
  1. I establish clear, long-term objectives that align with the company's vision and mission.
  1. I incorporate innovative approaches and being adaptable to change.
  1. I calculate return on investment (ROI) for various business projects.
What are your suggestions for how you can make improvements
in Business Acumen?


  1. Strengths


  2. Areas for Development


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