Cultural Awareness - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Cultural Awareness

• Shows respect in daily interactions
• Respects others regardless of age, race, gender, nationality, or disability.
• Encourages a work environment where individual differences are valued.
• Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
• Seeks out different viewpoints and benefits from different perspectives.

If [Participant Name] were to make improvements in Cultural Awareness, what are your suggestions for how he/she can improve this?

Customer Focus

• Asks questions and listens carefully to determine customer needs and to ensure that the customer's needs are met.
• Maintains positive customer relationships.
• Consistently models positive customer service attitudes.
• Ensures all customer commitments and requirements are met or exceeded.
• Does not hesitate to address customer concerns or complaints.

If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?

Flexibility

• Works effectively during periods of change.
• Adapts to circumstances as needed.
• Willing to try new ideas.
• Encourages others to adopt new procedures.
• Effective in incorporating new ideas.

If [Participant Name] were to make improvements in Flexibility, what are your suggestions for how he/she can improve this?

Punctuality

• Maintains an efficient schedule of activities.
• Invoices clients on a timely basis.
• Arrives to meetings on time.
• Conducts appointments at scheduled start time.
• Starts meetings on time.

If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Problem Solving

• Effective in solving problems.
• Solves problems using logic and insight.
• Ability to solve problems at root cause rather than at symptom level.
• Identifies and assesses all potential responses to a problem.
• Works cooperatively with others to solve problems.

If [Participant Name] were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?

Objectives

• Assures [Company] principles are understood, employed & pursued.
• Consistently provides me with timely feedback for improving my performance.
• Establishes goals and objectives.
• Organizes and schedules events, activities, and resources.
• Able to organize work.

If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?

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

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

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.