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
Avoids referring to stereotypes about others from different cultures.
Accepts individual differences.
Open to learning about different cultures.
Develops skills and attitudes to bridge cultural differences.
Supports and mentors others that may have different cultural backgrounds.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Coaches subordinates in how to make good decisions.
Shows consistency between what they say and do.
Treats all staff equitably.
Completes assessments in a timely manner.
Asks employees for their input in decisions that may directly affect the team.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Demonstrates a commitment to taking responsibility for actions.
Documents performance goals through an individual development plan.
Expects employees to accept the consequences of their actions.
Sets clear performance measures.
Regularly completes tasks on time.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fosters an environment built upon trust.
Establishes relationships of trust, honesty, fairness, and integrity.
Accepts responsibility for mistakes.
Does what was promised.
Fosters a high standard of ethics and integrity.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Seeks opportunities to grow in skills and knowledge.
Pursues professional development opportunities when they arise.
Is open to new ideas and concepts.
Takes the initiative to learn new skills.
Takes charge of their training and skills enhancement.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
...Overall Performance
...Produce Quality
Sets a high standard for job performance.
Listens and responds to issues and problems
Effective in performing his/her job.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes reports on-time.
Strong organizational skills to keep the workspace and department in order
Has strong technical/computer skills.
High attention to detail.
Able to develop, justify and present a budget.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Generates alternative solutions to problems and challenges.
Actively seeks the root cause of a problem.
Is a good problem solver and decision maker
Solves problems using logic and insight.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Works to identify root causes of performance problems
Sets and clearly communicates expectations, performance goals, and measurements to others
Takes immediate action on poor performance
Provides ongoing feedback to co-workers on their development progress
Adapts coaching and mentoring approach to meet the style or needs of individuals
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Successfully identifies complementary and compatible strategic partners with colleagues in the industry.
Balances the strategic interests of those involved to maintain alliances.
Facilitates the formation of collaborative relationships with suppliers and vendors.
Willingly participates on committees and project teams.
Maintains infrastructure to support partnerships and networks.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Willing to listen to the ideas of other team members.
Expresses appreciation for the work of other team members.
Helps the team make effective business decisions by ensuring the correctness of Company's reports/resources.
Focuses on understanding the other team member's message.
Fosters respect and understanding among team members
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has plans to handle unexpected events.
Determines the appropriate actions needed to achieve goals.
Develops strategic plans for ensuring competitiveness in the marketplace.
Creates a timeline for events and monitors progress.
Ensures staff have the supplies and resources necessary to enact the plan.

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: