Safety - 360 Degree Feedback Survey Sample #2

Instructions

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 and the goals they were asked to achieve. 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 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.

Please ensure that your submission is made between and . The survey will only be available during these dates.

Safety	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Supports our company's safety programs.
Performs work safely.
Develops a culture of safety.
Participates in safety training as applicable.
Is not afraid to question a potential safety issue observed in the workplace.
What are your suggestions for how can make improvements in Safety?
Continual Learning	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Builds on their strengths while addressing their weaknesses.
Pursues self-improvement through continual learning.
Shares best practices with others and learns from others.
Grasps new ideas, concepts, technical, or business knowledge.
Sets relevant learning objectives and goals.
What are your suggestions for how can make improvements in Continual Learning?
Attitude	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Builds open and trusting relationships.
Treats all people fairly and with respect.
Shows by their actions that they trust in the positive intentions of others.
Contributes to a positive and fun work environment.
Works to eliminate unnecessary work or barriers that get in others' way.
What are your suggestions for how can make improvements in Attitude?
Establishing Focus/Direction	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Makes sure that employees understand how their work relates to organizational goals.
Aligns the department's goals with the goals of the organization.
Maintains self-control when personally criticized.
Helps guide employees with prioritizing tasks.
Excellent at managing time.
What are your suggestions for how can make improvements in Establishing Focus/Direction?
Persuasion and Influence	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Attempts to persuade others rather than simply control them.
Ensures stakeholders are involved in the decision making process.
Develops a good rapport with others.
Persuades others to consider alternative points of view.
Able to express own goals and needs.
What are your suggestions for how can make improvements in Persuasion and Influence?
Problem Solving	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Is a good problem solver and decision maker
Effective in solving problems.
Solves problems using logic and insight.
Able to balance the needs of different people in a solution to a problem.
Identifies and assesses all potential responses to a problem.
What are your suggestions for how can make improvements in Problem Solving?
Juggling Multiple Responsibilities	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Maintains self-confidence and a positive mental attitude while facing challenging peaks and valleys of activities.
Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
Can multi-task while performing all of their other responsibilities and activities.
Bounces back from daily crisis, disappointments and frustrations.
Integrates developing others with driving sales, serving customers, merchandising, performing operational procedures, and maintaining an appealing store environment.
What are your suggestions for how can make improvements in Juggling Multiple Responsibilities?
Commitment To Result	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Able to focus on a task even when working alone.
Encourages commitment in others to obtain results.
Willing to do whatever it takes-not afraid to have to put in extra effort.
Maintains persistence and dedication to achieving results.
Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
What are your suggestions for how can make improvements in Commitment To Result?
Clarity	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Avoids stating unclear or conflicting goals.
Attends to the important details of a job or task.
Checks details thoroughly.
Avoids creating ambiguity or mixed messages.
Makes sure goals and objectives are clearly and thoroughly explained and understood.
What are your suggestions for how can make improvements in Clarity?
Client Focus	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Ensures client commitments and requirements are met or exceeded
Looks for opportunities that have a positive impact on Clients.
Obtains feedback to ensure client needs are being met.
Forms strong client relationships
Is pro-active in dealing with clients and addressing their needs.
What are your suggestions for how can make improvements in Client Focus?
Company	Clear Strength	Capable and Effective	Could Benefit from Development	Needs Significant Improvement
Understands how decisions impact other business units beyond their immediate department of work group.
Follows existing procedures and processes.
Impresses upon others the important aspects of [Company].
Attends [Company] gatherings and social events.
Expresses loyalty and dedication to [Company] in interactions with others.
What are your suggestions for how can make improvements in Company?

56. Strengths
    
    
    
57. Areas for Development
    
    
    
58. Please give any final comments or suggestions for 's assessment.