HR-Survey > 360-Degree Feedback > Competency Model > Safety Skills

Safety - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Safety:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
Survey 13 (4-point scale; numbers)
Survey 14 (4-point scale; N/A)
Instructions for Employees Participating in the 360-Feedback Assessment:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to receive feedback from a group of others. As part of this process, you will need to complete a self-assessment questionnaire at this time. 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 over the last 12 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 combined with the responses received from others and a report will be generated for you to foster growth and on-going 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.

Competencies Included:
Safety, Action, Punctuality, Analytical, Creativity, Achievement, Coaching, Business Acumen, Organizational Fluency
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

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


Safety

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You are aware of osha safety guidelines.
  1. You support safety programs and procedures.
  1. You identify predictable hazards in the workplace.
  1. You develop a culture of safety.
  1. You encourage others to attend safety training.
  1. You participate in safety training when available.
If you were to make improvements in Safety, what are your suggestions for how you can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. I fix small issues before they become critical incidents.
  1. You work quickly when faced with difficult problems.
  1. I take advantage of changes to the current situation.
  1. I act quickly to create innovative products and services.
  1. You fixe problems when they occur.
  1. I take the initiative to address problems sooner rather than later.
If you were to make improvements in Action, what are your suggestions for how you can improve this?

Punctuality

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You arrive to meetings on time.
  1. You respond to requests for information in a timely manner.
  1. You start the workday when scheduled.
  1. You conduct appointments at scheduled start time.
  1. You avoid making personal phone calls during working hours.
  1. You invoice clients on a timely basis.
If you were to make improvements in Punctuality, what are your suggestions for how you can improve this?

Analytical

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You implement data validation techniques and methods.
  1. You identifiy opportunities for progress and innovation.
  1. You ask the "right" questions to size up or evaluate situations.
  1. You select the appropriate techniques for analysis.
  1. You analyze data and information from several sources and arrives at logical conclusions.
  1. You identify the root cause of a problem.
If you were to make improvements in Analytical, what are your suggestions for how you can improve this?

Creativity

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You develop solutions to challenging problems.
  1. You conceive, implement and evaluate ideas.
  1. You are creative and inspirational.
  1. You are creative.
  1. You inspire creativity in your team.
  1. You add value to the department/organization.
If you were to make improvements in Creativity, what are your suggestions for how you can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You inspire others to work with a sense of urgency.
  1. You take calculated risks to achieve higher levels of performance.
  1. You eliminate bureaucratic barriers to streamline processes.
  1. You are determined to complete tasks regardless of obstacles that may occur.
  1. You take immediate action of projects that fall behind schedule.
  1. You accept setbacks and challenges as improvement opportunities
If you were to make improvements in Achievement, what are your suggestions for how you can improve this?

Coaching

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You develop the skills and capabilities of others.
  1. You provide clear, motivating, and constructive feedback.
  1. You conduct regular performance appraisals and feedback.
  1. You coach employees in how to strengthen knowledge and skills to improve work performance.
  1. You address employee behavior problems effectively.
  1. You meet regularly with employees to coach them on areas that will enhance your performance
If you were to make improvements in Coaching, what are your suggestions for how you can improve this?

Business Acumen

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You create a risk management strategy to meet the business needs of the organization.
  1. You ask the 'right' questions to size up or evaluate situations.
  1. You understand complex issues and problems.
  1. You create unique strategies that impact the Company.
  1. You view problems from a business perspective, opportunity, investment, risks, and anticipated results
  1. You anticipate customer's business needs.
If you were to make improvements in Business Acumen, what are your suggestions for how you can improve this?

Organizational Fluency

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. You get things done through the department.
  1. You are able to deal with sensitive issues with tact and professionalism.
  1. You are aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. You understand departmental policies and procedures.
  1. You understand the current organizational culture.
  1. You are able to explain departmental policies and procedures to others.
If you were to make improvements in Organizational Fluency, what are your suggestions for how you can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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