Safety - 360 Degree Feedback Survey Sample #6

360-Degree Assessment Survey

Dear Employee:

You have been selected to participate in a 360-assessment. As part of this process you will need to complete the self-assessment questionnaire below.

In responding to the questions below, think about your experiences over the last 12 months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question.

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.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. 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.


Management Team

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Safety	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I diligently record safety incidents.
You ensure all employees handle hazardous materials are properly trained.
You implement incentive plans to improve safety in the workplace.
You investigate the root causes of safety incidents.
You coordinate with internal teams and external agencies to ensure alignment on disaster recovery plans.
Bias for Action	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are very proactive and takes on many responsibilities not directly assigned.
I address minor issues early to prevent them from escalating into larger problems.
I approach tasks with enthusiasm and a problem-solving mindset that inspires colleagues.
I set deadlines and sub-deadlines on project to ensure a sense of urgency and adherence to a schedule.
You make decisions within a specific time limit to avoid overthinking about problems.
Integrity	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You can be trusted by others all the time and in every circumstance.
You always conduct yourself in an honest and upfront manner
You take responsibilities seriously and are dedicated to upholding both your own reputation and that of the department and organization.
You maintain composure and do not react rudely when confront with rude behavior to show self-control, emotional maturity, and integrity.
You can be trusted to do the right thing.
Cultural Awareness	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You treat others with dignity and respect.
I tailor solutions to accommodate diverse cultural needs and expectations.
I interact effectively with people from different cultural backgrounds.
I promote continuous learning about customs, traditions, and workplace etiquette.
You encourage open dialogue and ensure all voices are heard during team discussions.
Administrative Skill	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
I serve as a liaison to other departments.
You are effective at scheduling project activities and assignments.
You use proper spelling, capitalization, punctuation, and grammar in written documents.
I make travel arrangements and plans for executives.
You analyze financial transactions and their impacts in various reports.
Problem Solving	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You use a consistent method to evaluate each potential solution against the defined criteria.
You maximize the return on investment in problem-solving efforts by using resources wisely.
You ask the right questions to size up or evaluate situations.
I implement the ongoing tracking of key metrics and indicators to ensure the solution continues to perform as expected.
You work extra as needed to find the best solution to a problem.
Commitment	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You celebrate examples where employees embody commitment and values in customer interactions.
You maintain sustained engagement with the mission of the organization.
I build a culture where employees willingly contribute their skills to organizational success.
You create a compelling vision that employees see themselves in, transforming organizational goals into personal meaning.
You elevate customer experience by cultivating employee expertise and loyalty to organizational goals.
Technical	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You seek information from others as needed.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You demonstrate mastery of the technical competencies required in your work.
You willingly share your technical expertise; sought out as resource by others
Objectives	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You are able to organize work.
You work toward achieving established goals and objectives.
You effectively organize resources and plans
You set long-term and short-term goals.
You consistently provide me with timely feedback for improving my performance.
Trustworthy	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You communicate truthfully and openly, even when the message is difficult.
I foster an organizational climate in which leaders/managers are trusted by the employees.
You ensure employees take ownership of their work and understand the impact of their actions.
I make decisions based on ethical considerations, even when under pressure to do otherwise.
You promote clarity by openly discussing context, constraints, and reasoning behind decisions.
Negotiation	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You leverage relationships with others to achieve goals.
You maintain good interpersonal relationships with representatives from the other party.
You resolve difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.
I establish a strong, cooperative atmosphere; defines expectations; and presents a well-structured agenda aligned with key priorities.
I am a proficient conflict resolver who effectively navigates workplace disputes to maintain a harmonious and productive environment.
Strategic Focus	Needs Significant Improvement	Could benefit from Development	Capable and Effective	Role Model
You develop an organizational strategy for each functional area within the mission statement.
I identify sources for developing a global competitive advantage for the company.
I strategically position resources to meet the needs of branch locations.
I exploit resources and capabilities to strategically increase production and responsiveness.
I identify ways in which the company is better able to meet the customers' needs than rivals.

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

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

    
    
62. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
63. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
64. Additional comments, if any for [Participant Name Here]'s assessment.