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
Acknowledges their own biases in cultural interactions.
Understands what customs and etiquette are important for individuals from other cultures.
Is sensitive to the similarities and differences that exist between cultures.
Views diversity as a strength, not as an issue.
Hires individuals with different cultural backgrounds for the department.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is able to motivate others through persuasion rather than coercion.
Provides detailed feedback to employees.
Demonstrates empathy, respect, and openness to employees.
Sets clear expectations for acceptable performance.
Fosters an environment that supports open communication.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Able to complete required tasks on time and delivered expected results.
Informs the supervisor if progress on the task has been delayed.
Consistently strives to complete work on time or ahead of schedule.
Aware of the consequences for failure to complete the project.
Encourages employees to take on greater responsibilities.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows tasks to completion.
Accepts responsibility for mistakes.
Maintains strong relationships with others.
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.
Pursues professional development opportunities when they arise.
Sets relevant learning objectives and goals.
Views setbacks as opportunities to learn from.
Participates in regular training offered.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Sets a high standard for job performance.
Shown significant improvement in job performance.
...Produce Quality
Works well in this position.
Works effectively in the department.
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Has strong technical/computer skills.
Enthusiastic about taking on challenging projects.
Takes responsibility for decisions.
Implements and uses performance measures.
Able to develop, justify and present a budget.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and assesses all potential responses to a problem.
Generates alternative solutions to problems and challenges.
Implements effective solutions to critical problems.
Makes judgments based upon relevant information.
Identifies fresh approaches and shows a willingness to question traditional assumptions.
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
Adapts coaching and mentoring approach to meet the style or needs of individuals
Takes immediate action on poor performance
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Utilizes partners' key strengths to create mutual advantages.
Aligns efforts, processes, and resources with partners to maximize strategic opportunities.
Develops partnerships with other colleagues in the industry.
Builds alliances between departments and teams.
Develops key business contacts at other companies.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and resolves conflicts within the team to increase team effectiveness
Makes sure each team member participates in the task.
Communicates a clear message that teamwork and collaboration are expected.
Demonstrates a willingness to work with the team.
Works with other team members on the project.
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes market trends to plan the best course of action.
Understands what equipment will be needed for the project.
Makes strategic and tactical decisions to guide the logistics process.
Understands the process for developing strategic plans for the organization.
Creates effective project plans.

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: