Cultural Awareness - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for participating in a 360-degree feedback assessment. In this process, you will complete a self-assessment questionnaire (below). You will also receive feedback from others including your manager, peers and direct reports. As you respond, please respond using just your experiences in the past 12 months. Rate each item using the scale shown. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to you at the conclusion of this assessment to help guide your ongoing professional development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Please ensure that your submission is made by .

Thank you for your participation in the survey.

Management Team

Edit this Survey

Would you like to edit this survey? Click here to begin.

Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You treat others with dignity and respect.
I recognize individual and cultural differences.
I publicly acknowledge cultural contributions and achievements in team settings.
I seek knowledge and information about other cultures.
I participate in or facilitate cultural sensitivity training for self and team.
Innovation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I embrace disruptive strategies enabling the organization to create groundbreaking advancements that outpace competitors.
You suggest new ideas at meetings.
You implement the creative ideas of employees.
You look beyond company for new ideas and innovative approaches.
You promote innovation as an opportunity to gain competitive advantages in the marketplace.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are planful and organized.
You demonstrate the functional or technical skills necessary to do your job.
You can be counted on to add value wherever you are involved.
You demonstrate the analytical skills to do your job.
You keep yourself and others focused on constant improvement.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I regularly received positive feedback from clients.
You follow up with any unanswered questions from the client.
You address client complaints immediately.
You help others in responding to client needs.
You give feedback to the client regularly.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I ensure that above average performance is followed up with recognition.
I encourage peers to recognize each other in real-time.
I understand the recognition program resource requirements.
I am able to recognize the best (top performing) employees.
I recognize when the team excels on a project or reaches a major milestone.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You avoid conflicts of interest and disclose any potential bias in decision-making.
You ensure employees have all the tools and equipment need to maintain production schedules.
I can be trusted by colleagues to act with integrity.
I treat mistakes as learning opportunities, not punishable offenses.
I create a team structure that supports strong collaboration and communication.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You provide budgeting and accounting support to the Company.
You develop budgets and plans for various programs and initiatives.
You are effective in using company's resources.
You monitor spending.
You ensure others follow the correct rules and regulations on fiscal matters.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You cooperate with others on a global scale.
You engage in problem solving with individuals outside of the country.
You are able to listen and understand others and discuss issues in a respectful way.
You apply knowledge of overseas markets.
You align personal vision with global strategies.

41. Overall, please rate the effectiveness of [Participant Name Here].
    

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
42. Strengths
    
    
    
43. Areas for Development
    
    
    
44. Please give any final comments or suggestions for [Participant Name Here]'s assessment.