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
You are sensitive to the similarities and differences that exist between cultures.
You encourage a work environment where individual differences are valued.
You understand how implicit biases can affect decisions, communication and productivity.
You respect the views offered by individuals with different cultural backgrounds.
I am effective in working with individuals with a variety of cultural backgrounds.
Innovation	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You guarantee that team members are equipped with the technical expertise needed to excel in innovative projects.
You champion changes within the organization.
I provided incentives for employees who contribute innovative ideas and successfully implement them.
I participate in cross-functional innovation teams.
You look for new ways of doing things.
Excellence	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You produce high quality work.
You take a lot of pride in your work.
You demonstrate the analytical skills to do your job.
You demonstrate the functional or technical skills necessary to do your job.
You are planful and organized.
Client Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
I create an environment that enables clients to receive excellent service.
You form strong client relationships
I promptly respond to clients.
I am committed to resolving client issues in a positive way.
I make sure team members understand the issues faced by the client.
Recognition	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You recognize team members who offer a significant contribution to a project.
You compliment other people when they do good work
You reinforce and reward employees for accomplishing necessary goals.
You make people around them feel appreciated and valued.
You offer recognition in a timely manner.
Company	Role Model	Capable and Effective	Somewhat Effective	Needs Development
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 understand the "basics" as to how [Company] functions/operates.
You attend [Company] gatherings and social events.
You follow existing procedures and processes.
Fiscal Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You monitor expenses and verify the need for items purchased.
You develop of the department's annual budget.
You are effective in using company's resources.
You develop budgets and plans for various programs and initiatives.
You monitor spending.
Global Perspective	Role Model	Capable and Effective	Somewhat Effective	Needs Development
You demonstrate a curiosity about diverse individuals and cultures.
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 demonstrate working knowledge of global transactions.
You work well with others from different cultural backgrounds.
You communicate effectively on a multi-lingual basis.

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.