Cultural Awareness - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

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



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

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Cultural Awareness	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands how their own cultural background can impact the way they communicate and interact with others.
Participates in or facilitates cultural sensitivity training for self and team.
Consistently acknowledges and validates the contributions of team members from all backgrounds.
Engages with individuals that have different cultural backgrounds.
Builds trust by acknowledging and valuing each employee's cultural identity.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Delegates effectively.
Provides useful and constructive feedback to employees.
Completes assessments in a timely manner.
Offers constructive feedback to facilitate performance improvement.
Maintains professional interactions with peers, customers, and employees.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Documents performance goals through an individual development plan.
Exhibits a sense of ownership of the process.
Holds self and others accountable for meeting the deadline.
Keeps supervisor informed of recent events.
Holds team accountable to meeting goals.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Builds trust within the team and the organization through honest and transparent communication.
Fosters a high standard of ethics and integrity.
Maintains a strong unwavering support for professional standards and behavior.
Prioritizes ethical behavior over immediate gains ensuring that actions align with values and the best interests of all stakeholders.
Ensures that employees carry out their responsibilities with honesty and ethical principles.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Pursues learning that will enhance job performance.
Is open to new ideas and concepts.
Views setbacks as opportunities to learn from.
Pursues self-improvement through continual learning.
Improves on their skill sets.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works effectively in the department.
...Produce Quality
...Overall Performance
Effectively organizes resources and plans
Shown significant improvement in job performance.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Answers the phone promptly and politely.
Prepares and organizes presentations.
Prepares payroll and tax forms/reports.
Clearly and effectively communicates information verbally.
Ensures adequate supply levels by monitoring inventory and placing orders when necessary.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Weighs the pros and cons of proposed solutions.
Creates a table or chart to compare the solutions side-by-side across all evaluation criteria.
Analyzes alternatives and selects a course of action.
Resolves production and scheduling issues/problems.
Gathers input from staff for use in problem solving.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Provides ongoing feedback to co-workers on their development progress
Works to identify root causes of performance problems
Sets and clearly communicates expectations, performance goals, and measurements to others
Gives others development opportunities through project assignments and increased job responsibilities
Takes immediate action on poor performance
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Synchronizes efforts, processes, and resources with partners to enhance strategic opportunities.
Strives to cultivate and maintain a partnership based on trust and commitment in relationships.
Collaborates effectively with team members to achieve shared objectives and meet collective needs.
Manages effective partnerships between public, private, and non-profit sectors.
Facilitates open and honest communication to build trust and mutual respect.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters teamwork rather than individual competition
Demonstrates a willingness to work with the team.
Communicates a clear message that teamwork and collaboration are expected.
Listens to the opinions of other team members.
Is able to accurately paraphrase and summarize what other team members have said.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Determines staffing needs for the project/department.
Schedules staff based on seasonal needs.
Anticipates the impacts of strategic plans.
Identifies resource requirements that may impact the development of the 5-year plan.
Able to look ahead (beyond the present) when addressing the work/needs of the department.

61. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




62. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
63. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    
64. What changes do you see [Company] making in order to raise the standards?
    
    
    
65. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
66. What do you like best about working for [Company]?
    
    
    
67. What do you like least about working for [Company]? How could it be improved?
    
    
    
93. Use the space below to enter any final comments you would like to be noted: