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
Views diversity as a strength, not as an issue.
Is sensitive to the similarities and differences that exist between cultures.
Treats others with dignity and respect.
Encourages a work environment where individual differences are valued.
Seeks out different viewpoints and benefits from different perspectives.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keep staff informed about what is happening in the company
Sets an example for others to follow
Takes responsibility for things that go wrong
Delegate tasks effectively
Makes you feel enthusiastic about your work
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Makes sure that employees understand and identify with the team's mission.
Maintains focus when handling several problems or tasks simultaneously.
Functions well under stress, deadlines, and/or significant workloads.
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand how their work relates to organizational goals.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to adapt to new situations.
Can handle changes without complaining.
Is open to alternative ways to accomplish goals
Adapts to new organizational structures, policies, or procedures.
Acts decisively in frequently changing and uncertain environment.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is creative about the decisions they make.
Examines relevant factors needed to make a decision.
Is able to make decisions quickly.
Regularly evaluates information before making important decisions.
Decides which short- and long-term goals should be created.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Always strives to produce the highest quality work products.
Encourages employees to produce the best quality products.
Holds employees accountable for their quality of work.
Encourages others to achieve high quality standards.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Holds others accountable for producing high quality work.
Measures progress toward the goal.
Completed work exceeds standards.
Determines what resources will be needed to achieve the objectives.
Identifies the steps needed to accomplish the results.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keeps accurate safety records.
Points out behaviors in others that may be unsafe.
Is not afraid to question a potential safety issue observed in the workplace.
Develops safety guidelines for the department.
Encourages others to attend safety training.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Acts as a resource without removing individual responsibility.
Holds herself / himself accountable to goals / objectives
Sets a good example.
Sets a good example
Behavior is ethical and honest.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Researches the needs of the other party to identify strengths and weaknesses of positions.
Able to adapt to changing situations.
Maintains communication channels between parties in the negotiation.
Is flexible in responses.
Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Respects the opinions of other employees.
Able to see issues from others' perspectives.
Forms working relationships with employees from other departments.
Works across boundaries within the organization.
Helpful

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.