Safety - 360 Degree Feedback Survey Sample #7

360 Feedback Survey

Instructions

We are requesting your participation in a 360-degree feedback review of several participants in our company's Leadership Development program. We are 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 this manager'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.

You will get the chance to evaluate this manager's performance in different areas and share your thoughts through written comments for more detailed feedback. Ensure that your feedback is constructive and helpful.

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 .

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Safety	Needs Improvement		Fully Proficient		Excels/ Role Model	Not Applicable
Develops a safety program for the company.
Maintains accurate records regarding safety incidents and accidents.
Coordinates with external auditors and insurance risk consultants to assess organizational safety practices and ensure compliance.
Determines which safety issues require immediate attention.
Conducts regular worksite assessments to determine safety needs.
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
Makes eye contact with the person they are speaking with.
Listens actively & speaks clearly and directly.
Effectively engages with everyone from the CEO to external partners.
Transforms complicated ideas into simple ones.
Frequently communicates with the team.
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
My supervisor encourages me to think creatively.
Works across departments to stimulate creative ideas.
Promotes cross-training to broaden creative perspectives and skills.
Supports team-building and communication to foster a creative environment.
Leads by example with imaginative thinking and innovative action.
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
Seeks opportunities for continuous learning.
Encourages employees to take courses relevant to their job.
Allows employees to fully participate in employee training and professional development.
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for professional development.
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
Seeks input from team members, senior leaders, and external stakeholders to harness diverse perspectives and insights for informed decision-making and strategic planning.
Demonstrates a commitment to personal and professional growth through open acceptance of feedback results.
Invites and values input from others to gain a more comprehensive understanding of their abilities and areas where they can develop further.
Works with others to ensure a smooth feedback process.
Explores alternative perspectives or interpretations of feedback to broaden self-awareness.
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
Completes work to a high technical standard
Met required benchmarks for the position.
Encourages a culture of mentorship and continuous improvement, helping others reach their full potential.
Increased customer satisfaction scores for the quarter.
Aligns individual and team aspirations with organizational goals through strategic goal setting.
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
Assesses the risks of various strategic plans.
Ensures staff are held accountable for following the department plan.
Notifies staff when the plan is not on schedule.
Creates plans to handle complex, multi-faceted projects.
Prioritizes tasks based on urgency/need.
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.