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

• Is aware of differences in how individuals from other cultures greet one another.
• Is responsive to individuals from other cultures.
• Open to learning about different cultures.
• Recognizes and values individual and cultural differences.
• Understands how implicit biases can affect decisions, communication and productivity.

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

Customer Focus

• Creates innovative solutions for the customers.
• Promptly responds to customers.
• Considers customers point of view when making decisions.
• Is honest in all communication with the customers.
• 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

• Is open to alternative ways to accomplish goals
• Acts decisively in frequently changing and uncertain environment.
• Open to the perspectives/viewpoints of others.
• Able to adapt to new situations.
• Encourages others to adopt new procedures.

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

Punctuality

• Starts the workday when scheduled.
• Avoids making personal phone calls during working hours.
• Arrives to meetings on time.
• Maintains an efficient schedule of activities.
• 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

• Ability to solve problems at root cause rather than at symptom level.
• Able to balance the needs of different people in a solution to a problem.
• Effective in solving problems.
• Implements effective solutions to critical problems.
• Identifies and assesses all potential responses to a problem.

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

Objectives

• Encourages me to take on greater responsibility.
• Communicates goals and objectives to employees.
• Establishes goals and objectives.
• Effectively organizes resources and plans
• 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.