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)
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.

Competencies Included:
Cultural Awareness, Management, Communication Skills, Action, Project Management, Problem Solving, Technology Use/Management, Interpersonal Skills, Client Focus, Conflict Management, Strategic Insight, Global Perspective
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. Views diversity as a strength, not as an issue.
  1. Interacts effectively with people from different cultural backgrounds.
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Recognizes and values individual and cultural differences.
  1. Respects others regardless of age, race, gender, nationality, or disability.
Please feel free to provide any comments to help explain your answers?

Management

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. Delegate tasks effectively
  1. Keep staff informed about what is happening in the company
  1. Sets an example for others to follow
  1. Takes responsibility for things that go wrong
  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
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Competency
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Competency
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Competency
  1. Checks for understanding throughout conversations or group presentations/discussions
  1. Communicates with department leadership
  1. Conveys ideas confidently and succinctly.
  1. Listens to others' points of view with an open mind
  1. Able to demonstrate persuasiveness in pursuit of objectives.
Please feel free to provide any comments to help explain your answers?

Action

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
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Competency
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Competency
Always
Exhibits this
Competency
  1. Takes responsibility for meeting performance standards.
  1. Moves forward on important projects.
  1. Establishes the tasks and direction for the team.
  1. Prepares equipment at the start of the shift.
  1. Effectively makes decisions
Please feel free to provide any comments to help explain your answers?

Project Management

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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  1. Meets with stakeholders to determine the requirements for the project.
  1. Establishes communication protocols for messaging team members and stakeholders.
  1. Communicates the results of the project, at the conclusion, to all stakeholders.
  1. Formulates the schedule for the project phases, resoures usage, and benchmarks.
  1. Makes sure all team members understand their roles.
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
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Competency
Always
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Competency
  1. Effective in solving problems.
  1. Finds creative ways to get things done with limited resources.
  1. Identifies and assesses all potential responses to a problem.
  1. Ability to solve problems at root cause rather than at symptom level.
  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
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Competency
Sometimes
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Competency
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Competency
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Competency
  1. Supports technical training and development of employees.
  1. Adopts the implementation of new technology into the workplace.
  1. Proficient in the use of technical systems and processes.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Supports employee training and development initiatives regarding implementation of technology.
Please feel free to provide any comments to help explain your answers?

Interpersonal Skills

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. Is someone you can trust.
  1. Demonstrates a high degree of ethics and integrity in the workplace.
  1. Builds a strong rapport with co-workers.
  1. Offers praise to colleagues who have successfully completed major projects.
  1. Embraces the differences in individuals that comprise the team.
Please feel free to provide any comments to help explain your answers?

Client Focus

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Able to handle difficult clients.
  1. Puts client's needs first.
  1. Responds to the needs of the client.
  1. Is committed to the success of the client.
  1. Obtains feedback to ensure client needs are being met.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
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Competency
Seldom
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Competency
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Competency
  1. Deals effectively with employee grievances.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Clearly expresses expectations to others.
  1. Discusses conflict situations with supervisor.
  1. Assists team members by helping them see the other point of view.
Please feel free to provide any comments to help explain your answers?

Strategic Insight

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
Usually
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Competency
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Competency
  1. Works with others to develop insights into the resources and actions required to produce desired results.
  1. Strategically aligns projects to the goals of the company.
  1. Observes employees at work to get better insight into the issues they are dealing with.
  1. Identifies potential problems before they become critical incidents.
  1. Formulates policies and strategies for addressing the Company's important challenges.
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. 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.
  1. Able to listen and understand others and discuss issues in a respectful way.
  1. Able to work with others from different cultures and countries.
  1. Is aware of the culture, behaviors, identities and beliefs of others.
  1. Volunteers for experiences and assignments abroad.
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.