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
Treats others with dignity and respect.
Seeks to reduce obstacles in communication that might arise from cultural differences.
Values the diverse perspectives from others.
Functions effectively within various cultural contexts.
Participates in cultural training sessions/classes.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Understands the importance of good performance management.
Shows consistency between what they say and do.
Facilitates conversations where each person can be heard.
Effectively uses rewards to help motivate employees.
Provides useful and constructive feedback to employees.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Holds team accountable to meeting goals.
Implements and facilitates controls and processes that maintain the integrity of the organization.
Accepts accountability for their actions and results.
Tackles issues head on and finds solutions.
Is aware of problems or issues that may affect the organization.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does what was promised.
Maintains strong relationships with others.
Fosters an environment built upon trust.
Demonstrates honesty and truthfulness at all times.
Demonstrates sincerity in actions with others.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Pursues self-improvement through continual learning.
Builds on their strengths while addressing their weaknesses.
Pursues professional development opportunities when they arise.
Pursues learning that will enhance job performance.
Seeks opportunities to grow in skills and knowledge.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Listens and responds to issues and problems
Works well in this position.
Sets a high standard for job performance.
Able to organize work.
...Produce Quality
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes reports on-time.
Has strong technical/computer skills.
Accurately implements contract provisions.
Able to develop, justify and present a budget.
Implements and uses performance measures.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Actively seeks the root cause of a problem.
Able to balance the needs of different people in a solution to a problem.
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Works cooperatively with others to solve problems.
Ability to develop innovative solutions to problems.
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
Takes immediate action on poor performance
Adapts coaching and mentoring approach to meet the style or needs of individuals
Sets and clearly communicates expectations, performance goals, and measurements to others
Works to identify root causes of performance problems
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Supports a partnering/networking culture.
Maintains infrastructure to support partnerships and networks.
Builds alliances between departments and teams.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Forges mutually beneficial relationships between individuals with diverse backgrounds.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates a culture that fosters and values collaboration.
Works cooperatively with others to solve problems.
Provides assistance and support to other team members when needed
Seeks and listens to other's contributions
Willingly share their technical expertise
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Assigns the right tasks to the right people and holds them accountable.
Accomplishes major tasks by breaking them into manageable pieces.
Anticipates challenges and has plans to overcome them.
Closely follows the plan established for the department.
Always has a "Plan-B" ready if needed.

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: