Cultural Awareness - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

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Cultural Awareness

What does Cultural Awareness mean?
It means that ...

• I view diversity as a strength, not as an issue.
• You seek out different viewpoints and benefits from different perspectives.
• I intervene respectfully when witnessing culturally insensitive behavior or language.
• You understand the impact that your culture may have on interactions between individuals.
• You communicate with others without the influence of racism.

To what extent does this person exhibit Cultural Awareness?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Creativity

What does Creativity mean?
It means that ...

• You are able to innovate valuable ideas for new products.
• You use fresh insights to reimagine existing approaches.
• I invent new approaches when exist methods fall short.
• You inspire creativity in your team.
• You synthesize learned information into innovative designs.

To what extent does this person exhibit Creativity?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Feedback

What does Feedback mean?
It means that ...

• You address any issues discover during the feedback process.
• I conduct effective performance feedback conversations by focus on helping the employee's career development.
• You share past experiences with others as learning opportunities.
• You conduct seminars on effective communication, offering self-assessment resources, and deploying feedback frameworks.
• I proactively gather and integrate feedback from diverse sources.

To what extent does this person exhibit Feedback?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Administrative Skill

What does Administrative Skill mean?
It means that ...

• I actively seek to assist others in need.
• You give and follow oral instructions.
• I prepare and send email communications, meeting invitations, or follow-up messages on behalf of individuals or teams.
• You ensure proper passports, visas, or travel documents are in order and prepare any necessary documentation for travel.
• You take the time to grasp the points being made, and ensure individuals feel heard.

To what extent does this person exhibit Administrative Skill?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Teamwork

What does Teamwork mean?
It means that ...

• I express appreciation for the work of other team members.
• You willingly share your technical expertise
• You appreciate the input from other team members.
• You foster teamwork rather than individual competition
• You communicate a clear message that teamwork and collaboration are expected.

To what extent does this person exhibit Teamwork?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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