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
Commits adequate resources toward safety measures.
Is aware of OSHA safety guidelines.
Develops a sustainable safety culture.
Identifies predictable hazards in the workplace.
Identifies and addresses 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
Marks their status as "available" to signal they are open for communication.
Articulates ideas and emotions clearly to others.
Keeps the supervisor informed about achievements and milestones.
Sets their on-line status to "available" to indicate they are available for communication.
Persuasive and articulate when communicating.
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.
Inspires creativity in their team.
Develops solutions to challenging problems.
Creates a lot of new ideas.
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
Encourages employees to take courses relevant to their job.
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for continuous learning.
Contributing fully to the extent of their skills
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
Accepts the views of others.
Is visible and approachable.
Considers other's opinion and suggestions.
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.
Created impactful reports for the re-organization committee.
Takes calculated risks to achieve higher levels of performance.
Takes calculated risks to achieve significant rewards.
Works at a quick pace to complete a high volume of work.
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
Understands the process for developing strategic plans for the organization.
Conducts regular assessments of the project status to ensure adherence to the set schedule.
Accurately estimates the amount of materials/supplies needed for the project.
Understands what materials will be required to successfully implement the plan.
Allows input from others for the 5-year 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.