Safety - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to our 360-Degree Feedback Assessment of [Participant Name]. Our objective is to provide feedback which will help advance his/her leadership skills and capabilities. We are asking you to take time to respond to this survey to help us identify where we are doing well and where we have opportunities to do better.

We have developed this survey with questions tailored for [Participant Name]'s position in the department to provide you with an opportunity to anonymously rate many facets of his/her leadership performance. The survey will assess what you value most in their leadership skills and allow you to make positive suggestions for improvement.

Please be honest, constructive and thoughtful in your responses. The results of this survey will be used to help drive our future success. If you have any questions about the process please contact [Contact Person].

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



Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.

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Safety	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Ensures compliance with safety regulations.
Supports our company's safety programs.
Works to implement corrective safety measures.
Participates in safety training when offered.
Mitigates hazards and safety issues that arise.
Time Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Avoids delays by working quickly.
Allows for time buffers between tasks so that the schedule does not become delayed.
Identifies tasks that can be reassigned to others to prioritize high-impact leadership responsibilities.
Is concerned about adhering to the schedule.
Utilizes batch workflows to reduce time spent on certain tasks.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Analyzes interpersonal problems instead of reacting to them.
Consciously controls own negative emotions in order to keep team morale up.
Does not allow own emotions to interfere with the performance of others.
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Creates the metrics used to measure progress on the project.
Communicates with all employees involved on the project.
Acquires and allocates internal and external resources needed for the project.
Keeps accurate records regarding the costs of various aspects of the project.
Engages with individuals internally and externally to support the implementation of the project.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Is open and honest to avoid misunderstandings.
Ensures that both parties work toward finding compromise.
Evaluates the potential consequences of different resolution paths, weighing risks, trade-offs, and long-term impacts.
Prevents minor issues from escalating into major problems.
Demonstrates how to de-escalate through tone, body language, and word choice.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Connects unrelated concepts or data points to form innovative solutions that others may overlook.
Acknowledges how personal preferences or blind spots may skew judgment and takes steps to counteract them.
Builds decisions with contingency plans and modular thinking to accommodate future change.
Performs a cost/benefit analysis before making a decision.
Views the long and short-term impact of decisions.
Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Fixes small issues before they become critical incidents.
Takes on additional responsibilities outside of the job description to help the team succeed.
Seeks new opportunities for advancement.
Is proactive in developing solutions to problems.
Prevents small issues from becoming critical incidents.
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains compliance with federal, state, and local laws.
Develops compliance reports to share with stakeholders.
Coordinates the work of other Business Managers to ensure all are in compliance with established standards and guidelines.
Ensures the company is in compliance with industry specifications, standards, and applicable laws.
Performs annual/monthly compliance audits.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains communication channels with colleagues in the industry.
Shares and develops cutting-edge ideas with a network of colleagues, fostering a culture of innovation and continuous improvement.
Sustains existing partnerships guided by contracts and agreements.
Forms strategic partnerships and business alliances to expand opportunities.
Exchanges ideas, resources, plans, and technologies with colleagues.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Leverages internal expertise and external partnerships to expand strategic capabilities.
Creates strategies that significantly benefit the Company.
Translates complex industry trends into actionable strategies for the team/department.
Meets with customers to gain insight into their core needs and how best to serve them.
Develops a plan and strategy for each functional area within the mission statement.

51. On a scale of Excellent to Poor, how would you rate your overall employment with [Company] and why?
    

    -Excellent -Good -Average -Poor




52. Would you refer others who are seeking employment to [Company]?
    Yes No
    
    Please provide explanation:
    
    
    
53. If you had an opportunity to make any change you wanted to make [Company] a better place to work, what one improvement would you make?
    
    
    
54. What changes do you see [Company] making in order to raise the standards?
    
    
    
55. I feel good about my continued employment with [Company].
    Yes No
    
    If no, please provide explanation:
    
    
    
56. What do you like best about working for [Company]?
    
    
    
57. What do you like least about working for [Company]? How could it be improved?
    
    
    
93. Use the space below to enter any final comments you would like to be noted: