Cultural Awareness - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to the Employee Survey. Our objective is to understand and express the values which will ensure is an exceptional place to work. 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 our staff and business to provide you with an opportunity to anonymously rate many facets of the business. The survey will assess what you value most in your employment 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 and . 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.
Respects others regardless of age, race, gender, nationality, or disability.
Shows respect in daily interactions
Encourages a work environment where individual differences are valued.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Supervisory Skills	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains good working relationships with employees.
Treats all staff equitably.
Promotes teamwork and cooperation within the department.
Provides constructive, ongoing feedback.
Encourages employees to achieve their full potential.
Accountability	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Develops goals and establishes objective measures of success.
Creates a consistent process for prioritizing work.
Is aware of problems or issues that may affect the organization.
Tackles issues head on and finds solutions.
Defines roles, rights, and responsibilities of employees.
Integrity	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Establishes relationships of trust, honesty, fairness, and integrity.
Demonstrates sincerity in actions with others.
Accepts responsibility for mistakes.
Does what was promised.
Follows tasks to completion.
Continual Learning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Pursues self-improvement through continual learning.
Sets relevant learning objectives and goals.
Grasps new ideas, concepts, technical, or business knowledge.
Shares best practices with others and learns from others.
Builds on their strengths while addressing their weaknesses.
Performance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Shown significant improvement in job performance.
Sets a high standard for job performance.
...Produce Quality
Able to organize work.
Listens and responds to issues and problems
Administrative Skill	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Implements and uses performance measures.
Completes reports on-time.
Takes responsibility for decisions.
Has strong technical/computer skills.
High attention to detail.
Problem Solving	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Effective in solving problems.
Able to balance the needs of different people in a solution to a problem.
Ability to solve problems at root cause rather than at symptom level.
Solves problems using logic and insight.
Identifies and assesses all potential responses to a problem.
Co-worker Development	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Adapts coaching and mentoring approach to meet the style or needs of individuals
Gives others development opportunities through project assignments and increased job responsibilities
Provides ongoing feedback to co-workers on their development progress
Sets and clearly communicates expectations, performance goals, and measurements to others
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Partners with peers to obtain influence within the Company.
Creates the conditions for partnerships to grow and develop.
Collaborates with others to accomplish goals and objectives.
Develops a sense of trust in subordinates so they can freely interact and share information with others.
Builds alliances between departments and teams.
Teamwork	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Communicates a clear message that teamwork and collaboration are expected.
Actively participates as a team member
Provides assistance and support to other team members when needed
Builds consensus and shares relevant information.
Relates to all kinds of people tactfully
Planning	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Anticipates obstacles and ways to overcome them.
Makes plans and follows through.
Works in an organized manner
Able to look ahead (beyond the present) when addressing the work/needs of the department.
Able to identify the needs of the department before a major change.

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

    -Excellent -Good -Average -Poor

    
    

61. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
62. 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?
    
    
    
    
63. What changes do you see [Company] making in order to raise the standards?
    
    
    
64. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
    
65. What do you like best about working for [Company]?
    
    
    
66. 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: