Safety - 360 Degree Feedback Survey Sample #1

Instructions:

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

You have been selected to provide feedback on the employee listed above. 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 working with this employee over the last twelve 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 aggregated with the responses received from others and discussed with the employee 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.

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 and . 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
Supports safety programs and procedures.
Encourages others to work safely.
Mitigates hazards and safety issues that arise.
Creates accurate and effective measures of safety.
Develops a strong safety culture.
If were to make improvements in Safety, what are your suggestions for how he/she can improve this?
Action	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Motivates & supports others to gain skills
Works quickly when faced with difficult problems.
Is not afraid to take corrective action when necessary.
Makes effective decisions, even when under pressure.
Effectively makes decisions
If were to make improvements in Action, what are your suggestions for how he/she can improve this?
Punctuality	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Starts the workday when scheduled.
Starts meetings on time.
Invoices clients on a timely basis.
Responds to requests for information in a timely manner.
Avoids making personal phone calls during working hours.
If were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?
Analytical	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Asks the "right" questions to size up or evaluate situations.
Analyzes data and information from several sources and arrives at logical conclusions.
Uses appropriate techniques to solve problems.
Identifies the root cause of a problem.
Can effectively interpret and analyze data.
If were to make improvements in Analytical, what are your suggestions for how he/she can improve this?
Creativity	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Is creative.
Is creative and inspirational.
Inspires creativity in their team.
Conceives, implements and evaluates ideas.
Creates a lot of new ideas.
If were to make improvements in Creativity, what are your suggestions for how he/she can improve this?
Achievement	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
Completes work to a high technical standard
Follows-up and takes action when goals are not met to ensure better results in the future.
Accepts setbacks and challenges as improvement opportunities
Demonstrates a well-organized and timely approach to achieve desired results
If were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Coaching	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Helps employees to understand responsibilities, authority, and expectations.
Coaches employees in how to strengthen knowledge and skills to improve work performance.
Provides clear, motivating, and constructive feedback.
Meets regularly with employees to coach them on areas that will enhance their performance
Addresses employee behavior problems effectively.
If were to make improvements in Coaching, what are your suggestions for how he/she can improve this?
Business Acumen	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Effectively develops and uses resources (people, time, money, supplies, equipment, and space) to improve organizational performance
Applies the knowledge of work processes to influence the achievement of business goals
Able to align resources to meet the business needs of the company.
Exhibits behavior that is consistent with the vision, mission, and core values of the organization
Considers impact of actions on other areas of the organization.
If were to make improvements in Business Acumen, what are your suggestions for how he/she can improve this?
Organizational Fluency	Needs Improvement	Meets Minimum Standards	Is Proficient	Role Model
Anticipates problems that may affect the department.
Gets things done through the department.
Able to use corporate politics to advance department objectives.
Understands departmental policies and procedures.
Effective in communicating with others within the organization.
If were to make improvements in Organizational Fluency, what are your suggestions for how he/she can improve this?

46. What are 's greatest strengths demonstrated this year?
    
    
    
47. What are 's areas for development?
    
    
    
48. Please give any final comments or suggestions for 's assessment.