Cultural Awareness - 360 Degree Feedback Survey Sample #3





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

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

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







Cultural Awareness

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Aware of their own cultural views.
  1. Supports and mentors others that may have different cultural backgrounds.
  1. May advocate for others with different cultural backgrounds.
  1. Understands the impact that our culture may have on interactions between individuals.
  1. Seeks clarification to avoid misunderstandings.
Please feel free to provide any comments to help explain your answers?

Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Sets an example for others to follow
  1. Makes you feel enthusiastic about your work
  1. Takes responsibility for things that go wrong
  1. Delegate tasks effectively
  1. Is ready to offer help
Please feel free to provide any comments to help explain your answers?

Communication Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Delivers messages with energy, enthusiasm, and conviction.
  1. Communicates goals of project, resources required, resources available, etc. to the team
  1. Coaches others and provides feedback on the use of different oral communication styles for different audiences
  1. Shares important information with others.
  1. Has the confidence to communicate effectively to all levels (from CEO down) of the organization, external customers, suppliers, as well as the senior counsel of other companies.
Please feel free to provide any comments to help explain your answers?

Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Focuses on tasks without being distracted.
  1. Moves forward on important projects.
  1. Works across organizational lines and boundaries to attain goals.
  1. Motivates & supports others to gain skills
  1. Establishes the tasks and direction for the team.
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Conducts a risk assessment for the project.
  1. Assigns project roles to the team members.
  1. Identifies the source materials that will be needed.
  1. Correctly estimates the cost of supplies for the project.
  1. Determines the correct order for the phases of the project.
Please feel free to provide any comments to help explain your answers?

Problem Solving

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Generates alternative solutions to problems and challenges.
  1. Finds creative ways to get things done with limited resources.
  1. Works cooperatively with others to solve problems.
  1. Actively seeks the root cause of a problem.
  1. Able to balance the needs of different people in a solution to a problem.
Please feel free to provide any comments to help explain your answers?

Technology Use/Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Maximizes the use of new technology to deliver products and services.
  1. Identifies gaps between actual and needed technical competencies and provides recommendations for required training.
  1. Understands and is committed to implementing new technologies.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Uses technology in decision making and problem solving.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Maintains a high degree of honesty and integrity.
  1. Expresses appreciation of other's work.
  1. Maintains open and regular communication with others.
  1. Values the input from coworkers.
  1. Appreciates the extra efforts made by coworkers.
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Takes the initiative in solving difficult client issues.
  1. Maintains strong relationships with clients.
  1. Builds products that meet the unique needs of each client.
  1. Their activities reflect a strong focus on the client relationship.
  1. Consistently demonstrates a client focus.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Identifies the root sources of conflict.
  1. Does not let minor issues escalate into major problems.
  1. Identifies and takes steps to prevent potential confrontations.
  1. Identifies areas of agreement and common ground to form basis of resolution.
  1. Possesses the necessary skills to manage conflict and relationships.
Please feel free to provide any comments to help explain your answers?

Strategic Insight

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Lets employees know how their roles contribute toward the achievement of strategic company objectives.
  1. Identifies root causes of problems.
  1. Adjusts strategic plans based on insights gathered from different points of view.
  1. Pursues strategic alliances with valued partners.
  1. Ensures that the department's goals are strategically aligned with the company's goals.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Creates an environment where individual differences are valued and supported.
  1. Is able to work with individuals having different backgrounds and cultures.
  1. Forms strong client relationships with international partners.
  1. Volunteers for experiences and assignments abroad.
  1. Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
Please feel free to provide any comments to help explain your answers?

  1. Overall, please rate the effectiveness of [Participant Name].






  2. Strengths


  3. Areas for Development


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