Cultural Awareness - 360 Degree Feedback Survey Sample #2

Instructions

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 and the goals they 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 be 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.

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

Cultural Awareness	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Shows respect in daily interactions
Seeks out different viewpoints and benefits from different perspectives.
Fosters a diverse workforce free from discrimination and harassment.
Values the opinions of diverse groups and individual.
Treats others with dignity and respect.
What are your suggestions for how can make improvements in Cultural Awareness?
Managing Performance	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Sets and maintains high standards for self and others.
Makes sure commitments are understood and met.
Obtains commitment from employees regarding completion of tasks.
Examines the most effective ways for accomplishing goals.
Measures performance against goals and objectives.
What are your suggestions for how can make improvements in Managing Performance?
Creativity	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Is creative and inspirational.
Adds value to the department/organization.
Is creative.
Develops solutions to challenging problems.
Creates a lot of new ideas.
What are your suggestions for how can make improvements in Creativity?
Feedback	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Looks to others for input.
Asks others for their ideas and opinions.
Considers other's opinion and suggestions.
Is easy to approach with ideas and opinions.
Actively seeks feedback from others.
What are your suggestions for how can make improvements in Feedback?
Attitude	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Shows by their actions that they trust in the positive intentions of others.
Contributes to a positive and fun work environment.
Works to eliminate unnecessary work or barriers that get in others' way.
Builds open and trusting relationships.
Treats all people fairly and with respect.
What are your suggestions for how can make improvements in Attitude?
Decision Making	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Seeks input from key people who should be involved in, or will be affected by, decisions
Exercises good judgment by making sound and informed decisions.
Asks for additional information when making critical decisions.
Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
What are your suggestions for how can make improvements in Decision Making?
Innovation	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Builds upon the ideas and solutions of others.
Challenges current procedures to develop other alternatives.
Offers constructive improvements to existing systems.
Suggests new ideas at meetings.
Implements best practices within the department.
What are your suggestions for how can make improvements in Innovation?
Achievement	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Accepts setbacks and challenges as improvement opportunities
Demonstrates a well-organized and timely approach to achieve desired results
Systematically works to improve the organization
Follows-up and takes action when goals are not met to ensure better results in the future.
What are your suggestions for how can make improvements in Achievement?
Clarity	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Maintains clarity in goals and objectives.
Avoids stating unclear or conflicting goals.
Avoids creating ambiguity or mixed messages.
Attends to the important details of a job or task.
Clarifies problems and their causes to help employees correct them.
What are your suggestions for how can make improvements in Clarity?
Customer Focus	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
Develops strong customer relationships.
Does not hesitate to address customer concerns or complaints.
Consistently models positive customer service attitudes.
...friendliness and courtesy
What are your suggestions for how can make improvements in Customer Focus?
Recognition	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Recognizes team members who offer a significant contribution to a project.
Says "thank you" to show appreciation for work of others.
Compliments other people when they do good work
Is sincerely interested in the suggestions of co-workers
Recognizes individuals for a specific outstanding achievement.
What are your suggestions for how can make improvements in Recognition?
Business Acumen	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Understands complex issues and problems.
Able to align resources to meet the business needs of the company.
Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
Applies the knowledge of work processes to influence the achievement of business goals
Considers impact of actions on other areas of the organization.
What are your suggestions for how can make improvements in Business Acumen?

61. Strengths
    
    
    
62. Areas for Development
    
    
    
63. Please give any final comments or suggestions for 's assessment.