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
Effective in working with individuals with a variety of cultural backgrounds.
Is responsive to individuals from other cultures.
Recognizes and values individual and cultural differences.
Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
Interacts effectively with people from different cultural backgrounds.
Management	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Delegate tasks effectively
Takes responsibility for things that go wrong
Is ready to offer help
Sets an example for others to follow
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 how their work relates to organizational goals.
Aligns the department's goals with the goals of the organization.
Makes sure that employees understand and identify with the team's mission.
Excellent at managing time.
Sets appropriate goals for employees.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Willing to try new ideas.
Able to adapt to new situations.
Is open to alternative ways to accomplish goals
Can handle changes without complaining.
Adapts to new organizational structures, policies, or procedures.
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Has enough self-control to avoid making impulsive decisions.
Asks for additional information when making critical decisions.
Open to the suggestions from subordinates.
Is able to make decisions quickly.
Applies creative reasoning in making decisions.
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Always strives to produce the highest quality work products.
Encourages others to produce the highest quality work products.
Reflects on what is working and what could be improved.
Encourages others to achieve high quality standards.
Corrects issues in a timely manner.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Helps others when free-time is available.
Explains the "whys" behind organizational objectives
Directs team in prioritizing daily work activities
Provides clear expectations for employees.
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Is not afraid to question a potential safety issue observed in the workplace.
Works to implement corrective safety measures.
Is aware of OSHA safety guidelines.
Participates in safety training when available.
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.
...takes personal responsibility for results.
Sets high personal standards of performance.
Holds herself / himself accountable to goals / objectives
Behavior is ethical and honest.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Establishes good working relationships with others.
Able to adapt to changing situations.
Able to influence others to accept certain positions.
Researches the needs of the other party to identify strengths and weaknesses of positions.
Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Supports the efforts of other employees in implementing solutions to problems.
Consistently demonstrates ability and willingness to trust others.
Works effectively with people from other departments.
Treats others with respect and dignity.
Forms working relationships with employees from other departments.

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.