Safety - 360 Degree Feedback Survey Sample #4

Dear Employee:


Welcome to the Employee Survey. Our objective is to understand and express the values which will ensure is an exceptional place to work. 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 our staff and business to provide you with an opportunity to anonymously rate many facets of the business. The survey will assess what you value most in your employment 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 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

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
Keeps accurate safety records.
Develops a culture of safety.
Encourages others to work safely.
Is aware of OSHA safety guidelines.
Develops a strong safety culture.
Time Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Completes tasks ahead of schedule.
Avoids distractions in the workplace.
Focuses on tasks that have high priority.
Completes high-priority work within required timelines.
Deals effectively with interruptions.
Self Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
Analyzes interpersonal problems instead of reacting to them.
Does not allow own emotions to interfere with the performance of others.
Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
Consciously controls own negative emotions in order to keep team morale up.
Project Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Responds quickly and appropriately to unforeseen problems.
Develops action items, workplans, timelines, and criteria for projects.
Defines project outcomes based on customer requirements.
Able to adjust project schedule as needed to accommodate unforeseen issues.
Develops performance measures for various aspects of the project.
Conflict Management	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Identifies and takes steps to prevent potential confrontations.
Helps employees to think through alternative ways to resolve conflict situations.
Discusses conflict situations with supervisor.
Clearly expresses expectations to others.
Deals effectively with employee grievances.
Decision Making	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does not lose sight of the big picture when making decisions
Exercises good judgment by making sound and informed decisions.
Breaks complex issues into manageable parts and organizes them in a systematic way before making decisions
Assesses the risks, benefits, and potential impact of a number of options when deciding a course of action
Seeks input from key people who should be involved in, or will be affected by, decisions
Action	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Does whatever it takes (within reason) to get the job done.
Makes effective decisions, even when under pressure.
Is not afraid to take corrective action when necessary.
Gets the job done.
Drives and mobilizes others progress toward goals.
Regulatory/Compliance	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Follows all safety regulations and procedures.
Understands and adheres to internal and external regulations.
Addresses issues quickly before they develop into major problems.
Performs audits regularly, or without notice, to ensure proper compliance with regulations.
Understands the applicable regulations and laws that impact our business.
Partnering/Networking	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains infrastructure to support partnerships and networks.
Supports and encourages relationships that are created by diverse team members.
Creates value within the Company by building networks.
Creates the conditions for partnerships to grow and develop.
Builds alliances between departments and teams.
Strategic Insight	Needs Significant Development 1	2	Capable and Effective 3	4	Role Model 5
Maintains knowledge of current trends in the industry.
Implements long-term solutions to problems.
Anticipates business cycles and trends and makes adjustments in a timely manner.
Formulates strategies and action plans to ensure successful completion of goals and objectives.
Formulates policies and strategies for addressing the Company's important challenges.

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: