Cultural Awareness - 360 Degree Feedback Survey Sample #6

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 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 and . 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
Fosters a diverse workforce free from discrimination and harassment.
Seeks out different viewpoints and benefits from different perspectives.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Recognizes and values individual and cultural differences.
Values the opinions of diverse groups and individual.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Sets an example for others to follow
Takes responsibility for things that go wrong
Keep staff informed about what is happening in the company
Makes you feel enthusiastic about your work
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Stays focused even when under pressure and stress.
Makes sure that employees understand how their work relates to organizational goals.
Makes sure that employees understand and identify with the team's mission.
Functions well under stress, deadlines, and/or significant workloads.
Maintains focus when handling several problems or tasks simultaneously.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to try new ideas.
Adapts to circumstances as needed.
Effective in incorporating new ideas.
Works effectively during periods of change.
Identifies new opportunities to achieve goals
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Exercises good judgment by making sound and informed decisions.
Seeks input from key people who should be involved in, or will be affected by, decisions
Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
Does not lose sight of the big picture when making decisions
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Holds employees accountable for their quality of work.
Always strives to produce the highest quality work products.
Corrects issues in a timely manner.
Encourages others to produce the highest quality work products.
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
Inspires and motivates co-workers to be productive and energetic at work
Provides clear expectations for employees.
Explains the "whys" behind organizational objectives
Works toward achievement of goals even when confronted with obstacles.
Stays focused on meeting the needs of customers.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Keeps accurate safety records.
Creates accurate and effective measures of safety.
Develops safety guidelines for the department.
Commits adequate resources toward safety measures.
Performs work safely.
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.
Behavior is ethical and honest.
Is a person you can trust.
Acts as a resource without removing individual responsibility.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
Is able to decline bad ideas to avoid making poor decisions.
Influences others through rational argument and persuasion.
Leverages relationships with others to achieve goals.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Able to see issues from others' perspectives.
Is able to see issues from others' perspectives.
Helpful
Supports the efforts of other employees in implementing solutions to problems.
Works effectively with people from other departments.

56. Overall, please rate the effectiveness of .
    

    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 's assessment.