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. Seeks to reduce the likelihood of accidents.
  1. Mitigates hazards and safety issues that arise.
  1. Ensures that all supervisors are aware of regulatory and compliance measures.
  1. Performs work safely.
  1. Is not afraid to question a potential safety issue observed in the workplace.
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. Holds employees accountable for their quality of work.
  1. Always strives to produce the highest quality work products.
  1. Analyze what occurred and re-adjusts accordingly when goals are not met.
  1. Corrects issues in a timely manner.
  1. Encourages others to produce the highest quality work products.
Please feel free to provide any comments to help explain your answers?

Self Management

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Steps away from a situation to process appropriate response.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Identifies and takes steps to prevent potential confrontations.
  1. Helps employees to think through alternative ways to resolve conflict situations.
  1. Tries to understand others' point of view before making judgments
  1. Clearly expresses expectations to others.
  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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Keep staff informed about what is happening in the company
  1. Is ready to offer help
  1. Takes responsibility for things that go wrong
  1. Makes you feel enthusiastic about your work
  1. Delegate tasks effectively
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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Identifies problems and issues needing resolution.
  1. Prioritizes various actions to be taken when solving a problem.
  1. Identifies opportunities for progress and innovation.
  1. Analyzes issues and reduces them to their component parts.
  1. Selects the appropriate techniques for analysis.
Please feel free to provide any comments to help explain your answers?

Adaptability

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Is aware of changes to team personnel.
  1. Is open to change and adjusts plans when needed.
  1. Adjusts priorities to changing business goals.
  1. Can take on new assignments.
  1. Able to adjust to changes as needed.
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
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Works toward achievement of goals even when confronted with obstacles.
  1. Provides clear expectations for employees.
  1. Helps others when free-time is available.
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Directs team in prioritizing daily work activities
Please feel free to provide any comments to help explain your answers?

Customer Focus

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Provides excellent service to customers.
  1. Uses feedback from customers to help improve services.
  1. Focuses on maintaining good relationships with customers.
  1. Identifies the most pressing needs of each customer.
  1. Anticipates and proactively resolves issues that the customer may face.
Please feel free to provide any comments to help explain your answers?

Global Perspective

Does Not
Exhibit this
Competency
Seldom
Exhibits this
Competency
Sometimes
Exhibits this
Competency
Usually
Exhibits this
Competency
Always
Exhibits this
Competency
  1. Accepts setbacks and challenges in foreign markets as improvement opportunities
  1. Is able to work with individuals having different backgrounds and cultures.
  1. Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
  1. Sets the example for team on importance of cultural awareness.
  1. Able to listen and understand others and discuss issues in a respectful way.
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.