Cultural Awareness - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going development.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. 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

Cultural Awareness	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Understands the impact that our culture may have on interactions between individuals.
Is open and honest in communications with individuals from other cultures.
Open to learning about different cultures.
Seeks knowledge and information about other cultures.
Actively listens to other employees' stories about their culture.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is ready to offer help
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Takes responsibility for things that go wrong
Sets an example for others to follow
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Functions well under stress, deadlines, and/or significant workloads.
Sets appropriate goals for employees.
Excellent at managing time.
Makes sure that employees understand how their work relates to organizational goals.
Stays focused even when under pressure and stress.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is able to make accommodations needed for changes to the working conditions.
Embraces issues as opportunities to learn and grow.
Responds to changing availability of supplies and resources.
Allows for flexibility in setting realistic performance goals.
Adapts to new organizational structures, policies, or procedures.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Determines the costs and potential benefits of decisions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Makes decisions based on novel interpretations of the facts.
Is able to make decisions quickly.
Decides which long-term goals should be met.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages others to achieve high quality standards.
Provides regular and timely feedback on quality levels.
Corrects issues in a timely manner.
Maintains detailed instructions to ensure consistency and quality in the production line.
Effectively coordinates with other departments to improve quality.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Plans the best course of action to achieve the goal.
Responds to changing events to maintain progress toward achieving results.
Has a work ethic with a strong desire to obtain results.
Sets the objectives for the team.
Identifies the steps needed to accomplish the results.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Identifies and addresses safety needs.
Creates accurate and effective measures of safety.
Supports our company's safety programs.
Develops a sustainable safety culture.
Develops a culture of safety.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works in a way that makes others want to work with her/him.
Sets high personal standards of performance.
Completes assigned work tasks.
Sets a good example
Holds herself / himself accountable to goals / objectives
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes a positive connection with the other party to create a more collaborative atmosphere, making it easier to reach mutually beneficial agreements.
Identifies tradeable interests that could facilitate reaching a consensus.
Is prepared to walk away if core interests are not met.
Maintains communication channels between parties in the negotiation.
Clearly understands the interests and choices of both parties.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to see issues from others' perspectives.
Works effectively with people from other departments.
Includes others in the decision making processes.
Works across boundaries within the organization.
...treats others with respect and dignity.

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

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

    
    
57. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
58. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
59. Additional comments, if any for [Participant Name Here]'s assessment.