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

Cultural Awareness	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I develop skills and attitudes to bridge cultural differences.
I view diversity as a strength, not as an issue.
I actively listen to other employees' stories about their culture.
You acknowledge your own biases in cultural interactions.
You understand the impact that your culture may have on interactions between individuals.
Innovation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You take risks to advance important ideas.
You challenge current procedures to develop other alternatives.
You encourage open communication to ensure that all proposals are considered.
You implement best practices within the department.
You build upon the ideas and solutions of others.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are planful and organized.
You demonstrate the analytical skills to do your job.
You take a lot of pride in your work.
You produce high quality work.
You keep yourself and others focused on constant improvement.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I anticipate the resources needed to meet the client needs.
I create new and innovative products for clients.
You use feedback from clients to help improve services.
I keep the client informed of all progress.
You deliver high quality products to the client.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You recognize the abilities and skills of self and others
You find opportunities to recognize others.
You are sincerely interested in the suggestions of co-workers
You say "thank you" to show appreciation for work of others.
You compliment other people when they do good work
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You impress upon others the important aspects of [Company].
You express loyalty and dedication to [Company] in interactions with others.
You understand how decisions impact other business units beyond your immediate department of work group.
You attend [Company] gatherings and social events.
You understand the use of [Company] products and services.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You develop of the department's annual budget.
You monitor spending.
You ensure others follow the correct rules and regulations on fiscal matters.
You are effective in using company's resources.
You provide budgeting and accounting support to the Company.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You are comfortable using teleconferencing equipment to facilitate meetings with others abroad.
You understand and appreciate the perspectives offered by others with different cultural backgrounds.
You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
You can effectively deliver presentations to international clients.
You exemplify the skills of a global worker.

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.