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
Performs work safely.
Seeks to reduce the likelihood of accidents.
Identifies predictable hazards in the workplace.
Mitigates hazards and safety issues that arise.
Encourages others to attend safety training.
Continual Learning	Agree	Unsure	Disagree	N/A
Participates in regular training offered.
Pursues professional development opportunities when they arise.
Grasps new ideas, concepts, technical, or business knowledge.
Pursues self-improvement through continual learning.
Is open to new ideas and concepts.
Professional Development	Agree	Unsure	Disagree	N/A
Quickly acquire and apply new knowledge and skills when needed
Contributing fully to the extent of their skills
Keep themselves up-to-date of technical/professional issues
Seeks opportunities for continuous learning.
Allows employees to fully participate in employee training and professional development.
Emotional Intelligence	Agree	Unsure	Disagree	N/A
Is attentive to emotional cues and interprets others' feelings correctly.
Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
Accurately perceives the emotional reactions of others.
Able to understand others' points of view.
Is able to express themselves clearly.
Goals	Agree	Unsure	Disagree	N/A
Makes sure that I have a clear idea of our group's goals.
Understands & contributes to development of strategic goals.
Makes sure that team members have a clear idea of our group's goals.
Conducts timely follow-up; keeps others informed on a need to know basis.
Achieves established goals.
Results Oriented	Agree	Unsure	Disagree	N/A
Concentrates efforts on the most urgent needs.
Makes changes to the plans if it will result in increased output.
Directs team in prioritizing daily work activities
Sets the objectives for the team.
Produces a high volume of work.
Managing Risk	Agree	Unsure	Disagree	N/A
Determines the risk tolerance of the company.
Aligns risk management activities with existing processes.
Perceives the risks of different work tasks and activities.
Identifies what actions the organization is willing to take.
Designs risk management activities that support the success of the company.
Developing Others	Agree	Unsure	Disagree	N/A
Creates opportunities for professional development.
Sets performance objectives for subordinates that encourages development opportunities.
Is open to receiving feedback.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Creates a work environment that fosters positive feedback to employees.
Others	Agree	Unsure	Disagree	N/A
Respects the opinions of other employees.
...treats others with respect and dignity.
Includes others in the decision making processes.
Works across boundaries within the organization.
Consistently demonstrates ability and willingness to trust others.
Global Perspective	Agree	Unsure	Disagree	N/A
Demonstrates a curiosity about diverse individuals and cultures.
Develops both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
Analyzes global issues/problems that are having a large impact on the Company.
Engages in problem solving with individuals outside of the country.
Understands how cultures differ and how these differences impact work behavior.

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.