Cultural Awareness - 360 Degree Feedback Survey Sample #8

Instructions

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool 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 assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



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Cultural Awareness	Agree	Unsure	Disagree	N/A
Seeks out different viewpoints and benefits from different perspectives.
Communicates with others without the influence of racism.
Effective in working with individuals with a variety of cultural backgrounds.
Recognizes individual and cultural differences.
Recognizes and values individual and cultural differences.
Flexibility	Agree	Unsure	Disagree	N/A
Regularly assesses current methods, welcomes feedback, and is willing to implement changes to improve efficiency and effectiveness.
Responds to changing governmental regulations.
Is flexible in solving difficult problems.
Is flexible in responding to customer needs.
Fosters a culture where diverse perspectives are valued allowing the team to adapt more easily to changes and draw on a wider range of ideas and solutions.
Bias for Action	Agree	Unsure	Disagree	N/A
Conveys a sense of urgency about addressing problems and opportunities
Encourages risk taking and experimentation to improve performance
Completes work on time
Completes a large volume of work.
Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
Continual Improvement	Agree	Unsure	Disagree	N/A
Analyzes processes to determine areas for improvement.
Searches for new methods, techniques, and processes that increase efficiency and reduce costs.
Encourages an employee culture of continuous improvement to seek out better ways of doing things.
Looks for ways to expand and learn new job skills.
Promotes training and development opportunities to enhance job performance.
Punctuality	Agree	Unsure	Disagree	N/A
Starts the workday when scheduled.
Avoids making personal phone calls during working hours.
Responds to requests for information in a timely manner.
Maintains an efficient schedule of activities.
Conducts appointments at scheduled start time.
Innovation	Agree	Unsure	Disagree	N/A
Effective in bringing up new ideas.
Cultivates a culture of open communication where all ideas, no matter how unconventional, are welcomed and valued.
Supports innovation at all levels of the organization.
Encourages a search for radical innovation opportunities to obtain major breakthroughs.
Participates in cross-functional innovation teams.
Time Management	Agree	Unsure	Disagree	N/A
Performs high-impact work first.
Rarely misses deadlines; often producing results before expected.
Persists with crucial assignments.
Sets clearly defined goals.
Is prompt and diligent in their work.
Commitment To Result	Agree	Unsure	Disagree	N/A
Takes immediate action toward goals.
Able to focus on a task even when working alone.
Coordinates all department activities into a cohesive team effort.
Committed to the team.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Objectives	Agree	Unsure	Disagree	N/A
Communicates goals and objectives to employees.
Organizes and schedules events, activities, and resources.
Effectively organizes resources and plans
Encourages me to take on greater responsibility.
Establishes goals and objectives.
Client Focus	Agree	Unsure	Disagree	N/A
Gets feedback from the client on a weekly basis.
Uses feedback from the client to help improve the client's experience.
Anticipates and proactively resolves issues that the client may face.
Is pro-active in dealing with clients and addressing their needs.
Is honest in all communication with the clients.
Coaching	Agree	Unsure	Disagree	N/A
Conducts regular performance appraisals and feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Helps employees to maintain high personal standards.
Provides clear, motivating, and constructive feedback.
Develops the skills and capabilities of others.
Company	Agree	Unsure	Disagree	N/A
Impresses upon others the important aspects of [Company].
Understands the use of [Company] products and services.
Follows existing procedures and processes.
Understands how decisions impact other business units beyond their immediate department of work group.
Understands the "basics" as to how [Company] functions/operates.

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

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

    
    
62. Strengths
    
    
    
63. Areas for Development
    
    
    
64. Please give any final comments or suggestions for [Participant Name Here]'s assessment.