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
Shows respect in daily interactions
Fosters a diverse workforce free from discrimination and harassment.
Encourages a work environment where individual differences are valued.
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
Is ready to offer help
Keep staff informed about what is happening in the company
Delegate tasks effectively
Sets an example for others to follow
Takes responsibility for things that go wrong
Establishing Focus/Direction	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Aligns the department's goals with the goals of the organization.
Sets appropriate goals for employees.
Excellent at managing time.
Stays focused even when under pressure and stress.
Makes sure that employees understand and identify with the team's mission.
Flexibility	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Encourages others to adopt new procedures.
Effective in incorporating new ideas.
Acts decisively in frequently changing and uncertain environment.
Willing to try new ideas.
Implements changes as a result of having listened to employees
Decision Making	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
Asks for additional information when making critical decisions.
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Does not lose sight of the big picture when making decisions
Coaches team members individually when "poor" decisions are made; helps them see what could have been done differently
Quality	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Corrects issues in a timely manner.
Holds employees accountable for their quality of work.
Analyze what occurred and re-adjusts accordingly when goals are not met.
Encourages others to achieve high quality standards.
Reflects on what is working and what could be improved.
Results Oriented	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Helps others when free-time is available.
Demonstrates the personal confidence to "stay the course," even when faced with difficulty
Works toward achievement of goals even when confronted with obstacles.
Directs team in prioritizing daily work activities
Explains the "whys" behind organizational objectives
Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Creates accurate and effective measures of safety.
Supports our company's safety programs.
Develops safety guidelines for the department.
Encourages others to work safely.
Supports safety programs and procedures.
Responsible	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Completes assigned work tasks.
Behavior is ethical and honest.
Responsible for setting the vision of the department.
Sets a good example.
Acts as a resource without removing individual responsibility.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Conducts necessary preparations before engaging in negotiations.
Establishes good working relationships with others.
Able to say "no" when necessary to effectively execute business strategy and meet long-term objectives.
Establishes clear communications to avoid misunderstandings.
Changes communication styles to meet the listener's needs.
Others	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
Works effectively with people from other departments.
Helpful
Treats others with respect and dignity.
Is able to see issues from others' perspectives.
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.