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
Identifies predictable hazards in the workplace.
Participates in safety training when available.
Develops a culture of safety.
Supports our company's safety programs.
Keeps accurate safety records.
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
Is an effective communicator
Deals with difficult situations calmly and confidently.
Conveys ideas confidently and succinctly.
Addresses issues of key importance to stakeholders.
Chooses the communication medium (ie. email, voice mail, memo, project document) that reflects the needs of the content. (ie. urgency, confidentiality, content scope)
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.
Conceives, implements and evaluates ideas.
Is creative and inspirational.
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.
Seeks opportunities for continuous learning.
Quickly acquire and apply new knowledge and skills when needed
Seeks opportunities for professional development.
Keep themselves up-to-date of technical/professional issues
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
Accepts the views of others.
Actively seeks feedback from others.
Seeks feedback to enhance performance.
Is visible and approachable.
Looks to others for input.
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
Demonstrates a well-organized and timely approach to achieve desired results
Helps others to improve or meet standards of performance.
Makes use of talents of others to help achieve a high level of performance.
Is determined to complete tasks regardless of obstacles that may occur.
Rapidly completes tasks and assignments.
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
Always has a "Plan-B" ready if needed.
Establishes and monitors timeframes and timelines.
Develops a strategic plan to reduce costs in the department.
Sets up and monitors timeframes and plans
Involves relevant coworkers in the development of the plan.
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.