Safety - 360 Degree Feedback Survey Sample #8

Instructions

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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

Safety	Agree	Unsure	Disagree	N/A
Points out behaviors in others that may be unsafe.
Participates in safety training as applicable.
Participates in safety training when available.
Works to implement corrective safety measures.
Mitigates hazards and safety issues that arise.
Continual Learning	Agree	Unsure	Disagree	N/A
Sets relevant learning objectives and goals.
Shares best practices with others and learns from others.
Pursues self-improvement through continual learning.
Pursues learning that will enhance job performance.
Seeks opportunities to grow in skills and knowledge.
Professional Development	Agree	Unsure	Disagree	N/A
Seeks opportunities for continuous learning.
Keep themselves up-to-date of technical/professional issues
Demonstrate enthusiasm and a willingness to learn new skills and knowledge
Quickly acquire and apply new knowledge and skills when needed
Allows employees to fully participate in employee training and professional development.
Emotional Intelligence	Agree	Unsure	Disagree	N/A
Is able to manage their own emotions.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Is able to express themselves clearly.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Goals	Agree	Unsure	Disagree	N/A
Achieves established goals.
Achieves goals.
Establishes and documents goals and objectives.
Understands & contributes to development of strategic goals.
Goal Setting
Results Oriented	Agree	Unsure	Disagree	N/A
Explains the "whys" behind organizational objectives
Stays focused on meeting the needs of customers.
Works toward achievement of goals even when confronted with obstacles.
Directs team in prioritizing daily work activities
Inspires and motivates co-workers to be productive and energetic at work
Managing Risk	Agree	Unsure	Disagree	N/A
Able to adapt quickly to changing situations.
Effectively responds to critical situations to reduce potential for losses.
Seeks to retain the best and brightest employees.
Accurately perceives potential risks in the workplace and initiates preventative measures.
Develops appropriate strategies to minimize risks.
Developing Others	Agree	Unsure	Disagree	N/A
Supports the successes of other employees.
Creates opportunities for professional development.
Assesses employees' developmental needs.
Is open to receiving feedback.
Sets performance objectives for subordinates that encourages development opportunities.
Others	Agree	Unsure	Disagree	N/A
Respects the opinions of other employees.
Works across boundaries within the organization.
Consistently demonstrates ability and willingness to trust others.
Supports the efforts of other employees in implementing solutions to problems.
Is able to see issues from others' perspectives.
Global Perspective	Agree	Unsure	Disagree	N/A
Understands global systems such as the global economy.
Has positive interactions with individuals from different cultures and backgrounds.
Is able to work with individuals having different backgrounds and cultures.
Facilitates open communication with individuals from other countries.
Able to work with others from different cultures and countries.

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

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

    
    
52. Strengths
    
    
    
53. Areas for Development
    
    
    
54. Please give any final comments or suggestions for [Participant Name Here]'s assessment.