hr-survey.com

Safety - 360 Degree Feedback Survey Sample #3





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)
Instructions

You have been asked to evaluate yourself as part of a 360-degree feedback process. Other employees, including your manager(s), peers, and direct reports will also evaluate you. In this manner, you will be provided with a comprehensive, multi-perspective (i.e., 360-degree) view of your performance as a manager. The objective is to provide you with feedback so as to allow you to improve your performance, resulting in improved team performance, and organizational effectiveness.

If you are not able to respond to an item, leave it blank and go on to the next item.

Competencies Included:
Safety, Quality, Self Management, Conflict Management, Management, Analytical, Adaptability, Results Oriented, Customer Focus, Global Perspective
Sample Result Document:
Sample Results
We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

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




Safety

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is not afraid to question a potential safety issue observed in the workplace.
  1. Performs work safely.
  1. Points out behaviors in others that may be unsafe.
  1. Develops a sustainable safety culture.
  1. Participates in safety training when available.
Please feel free to provide any comments to help explain your answers?

Quality

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.
  1. Corrects issues in a timely manner.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Encourages others to achieve high quality standards.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
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Competency
Sometimes
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Competency
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Competency
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Exhibits this
Competency
  1. Steps away from a situation to process appropriate response.
  1. Does not allow own emotions to interfere with the performance of others.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Uses patience and self-control in working with customers and associates.
  1. Consciously controls own negative emotions in order to keep team morale up.
Please feel free to provide any comments to help explain your answers?

Conflict Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Exhibits this
Competency
Always
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  1. Identifies and takes steps to prevent potential confrontations.
  1. Deals effectively with employee grievances.
  1. Clearly expresses expectations to others.
  1. Discusses conflict situations with supervisor.
  1. Assists team members by helping them see the other point of view.
Please feel free to provide any comments to help explain your answers?

Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Exhibits this
Competency
Always
Exhibits this
Competency
  1. Takes responsibility for things that go wrong
  1. Sets an example for others to follow
  1. Delegate tasks effectively
  1. Is ready to offer help
  1. Keep staff informed about what is happening in the company
Please feel free to provide any comments to help explain your answers?

Analytical

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
Always
Exhibits this
Competency
  1. Identifies the root cause of a problem.
  1. Identifies opportunities for progress and innovation.
  1. Implements data validation techniques and methods.
  1. Prioritizes various actions to be taken when solving a problem.
  1. Uses appropriate techniques to solve problems.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Competency
  1. Able to adapt to changes in technology and processes.
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Adjusts priorities to changing business goals.
  1. Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
  1. Flexible and open to new ideas and encourages others to value change.
Please feel free to provide any comments to help explain your answers?

Results Oriented

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
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Competency
Always
Exhibits this
Competency
  1. Provides clear expectations for employees.
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Explains the "whys" behind organizational objectives
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
Please feel free to provide any comments to help explain your answers?

Customer Focus

Does Not
Exhibit this
Competency
Seldom
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Competency
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Competency
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Competency
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Exhibits this
Competency
  1. ...friendliness and courtesy
  1. Maintains positive customer relationships.
  1. Considers customers point of view when making decisions.
  1. Consistently models positive customer service attitudes.
  1. Develops good rapport and trust with the customer.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
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Competency
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Competency
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Exhibits this
Competency
  1. Understands global systems such as the global economy.
  1. Facilitates open communication with individuals from other countries.
  1. Excellent communication skills to conduct effective business with individuals from different cultures and/or countries.
  1. Can effectively deliver presentations to international clients.
  1. Is able to work with individuals having different backgrounds and cultures.
Please feel free to provide any comments to help explain your answers?

  1. Overall, please rate the effectiveness of [Participant Name].






  2. Strengths


  3. Areas for Development


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