Safety - 360 Degree Feedback Survey Sample #5

360-Degree Assessment Survey

Dear Employee:

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the Closing Comments section. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

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Thank you for your participation in the survey.

Management Team

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Safety	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Determines which safety issues require immediate attention.
Fosters an organizational culture that promotes health and safety.
Coordinates with internal teams and external agencies to ensure alignment on disaster recovery plans.
Prepares effective safety training materials.
Requires all supervisors to support the company safety initiatives.
Attitude	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Actively seeks insight from colleagues at all levels and backgrounds.
Faces setbacks with composure and reframes challenges as opportunities for growth.
Volunteers for tasks or initiatives that stretch their skills, showing eagerness to contribute and grow.
Expresses sincere appreciation for others' efforts -- regardless of how routine or behind-the-scenes they may be.
Strives to support team success through personal accountability and proactive effort.
Establishing Focus/Direction	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Understands the strengths and needs of each employee in the department.
Leads by example to guide employees in the completion of tasks.
Adjusts expectations and deliverables to accommodate evolving organizational needs.
Makes sure all employees understand the purpose for the project and the tasks they have been assigned.
Encourages employees to focus on getting results now.
Initiative	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Immediately works on solving problems.
Updates the documentation as soon as the situation changes.
Demonstrates resilience by learning from failed attempts and applying insights to future actions.
Initiates policy or process changes that become best practices across departments.
Seizes upon chances to improve the department's prospects.
Change Management	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Ensures high quality information is used to implement and/or adjust the changes.
Shares critical customer feedback to motivate the employees into action.
Reduces anxiety in the team/department to changes.
Quickly adapts to new environments.
Solicits input from management consultants.
Partnering/Networking	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Uses networks to create new business opportunities.
Partners with other organizations to develop new technologies and processes.
Expands network of colleagues to include others who may contribute to the department's success.
Seeks to reduce institutional roadblocks to information sharing.
Uses networks of personal contacts to gain introductions to others who may have valuable information.
Strategic Focus	Role Model	Capable and Effective	Somewhat Effective	Needs Development
Identifies sources for developing a global competitive advantage for the company.
Creates a strategy to achieve departmental objectives.
Ensures adherence to the strategy to sustain achievement of targeted levels of organizational performance.
Reinforces the strategic messaging in various teams, meetings, seminars and workshops.
Detects changes in the environment and updates the strategic plan to address new opportunities or threats.

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

    5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

    
    
37. Strengths
    
    
    
38. Areas for Development
    
    
    
39. Please give any final comments or suggestions for [Participant Name Here]'s assessment.