Safety - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

is administering a new web-based survey tool which is designed to gather broad feedback as it relates to core competencies and role responsibilities that are important for the on-going success of our organization. The Leadership Team Members have agreed to participate and are seeking your feedback.

In this regard, you have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Safety	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Is not afraid to question a potential safety issue observed in the workplace.
Ensures that all supervisors are aware of regulatory and compliance measures.
Participates in safety training when offered.
Encourages others to attend safety training.
Points out behaviors in others that may be unsafe.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?
Communication Skills	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Checks for understanding throughout conversations or group presentations/discussions
Communicates with department leadership
Visible and approachable; is there when you need them.
Responds to critical concerns of stakeholders.
Takes on challenging questions and provides instant answers.
If [Participant Name] were to make improvements in Communication Skills, what are your suggestions for how he/she can improve this?
Creativity	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Adds value to the department/organization.
Is creative and inspirational.
Creates a lot of new ideas.
Is creative.
Inspires creativity in their team.
If [Participant Name] were to make improvements in Creativity, what are your suggestions for how he/she can improve this?
Professional Development	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Allows employees to fully participate in employee training and professional development.
Contributing fully to the extent of their skills
Keep themselves up-to-date of technical/professional issues
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Encourages employees to take courses relevant to their job.
If [Participant Name] were to make improvements in Professional Development, what are your suggestions for how he/she can improve this?
Feedback	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Asks others for their ideas and opinions.
Seeks feedback to enhance performance.
Accepts the views of others.
Looks to others for input.
Shares past experiences with others as learning opportunities.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?
Achievement	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Motivated to exceed performance goals.
Increased customer satisfaction scores for the quarter.
Rapidly completes tasks and assignments.
Driven to complete goals despite obstacles that may arise.
Increased revenue for the company.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Planning	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Develops strategic plans for the company/organization.
Accurately estimates the amount of materials/supplies needed for the project.
Develops a detailed plan outlining tasks, resources, timelines, and deliverables.
Anticipates obstacles and ways to overcome them.
Anticipates challenges and has plans to overcome them.
If [Participant Name] were to make improvements in Planning, what are your suggestions for how he/she can improve this?

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