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
Develops safety guidelines for the department.
Performs work safely.
Ensures compliance with safety regulations.
Committed to safety in the workplace.
Mitigates hazards and safety issues that arise.
Continual Learning	Agree	Unsure	Disagree	N/A
Participates in regular training offered.
Is open to new ideas and concepts.
Builds on their strengths while addressing their weaknesses.
Pursues self-improvement through continual learning.
Takes the initiative to learn new skills.
Professional Development	Agree	Unsure	Disagree	N/A
Seeks opportunities for continuous learning.
Keep themselves up-to-date of technical/professional issues
Encourages employees to take courses relevant to their job.
Contributing fully to the extent of their skills
Quickly acquire and apply new knowledge and skills when needed
Emotional Intelligence	Agree	Unsure	Disagree	N/A
Is able to control their own emotions.
Is attentive to emotional cues and interprets others' feelings correctly.
Able to understand others' points of view.
Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
Accurately perceives the emotional reactions of others.
Goals	Agree	Unsure	Disagree	N/A
Achieves established goals.
Goal Setting
Understands & contributes to development of strategic goals.
Achieves goals.
Conducts timely follow-up; keeps others informed on a need to know basis.
Results Oriented	Agree	Unsure	Disagree	N/A
Is considered a high achiever.
Holds self and others accountable for achieving results.
Has a strong drive to complete goals despite obstacles that may arise.
Determines the parts of the project that need completed first.
Has a strong result orientation.
Managing Risk	Agree	Unsure	Disagree	N/A
Uses financial data to mitigate financial risks.
Tracks and monitors incidents that may increase the risk of adverse consequences.
Identifies opportunities that may be created by taking specific risks.
Committed to implementing rules and procedures to minimize risk.
Determines how the risk management information is to be used.
Developing Others	Agree	Unsure	Disagree	N/A
Recognizes and celebrates accomplishments of others.
Sets performance objectives for subordinates that encourages development opportunities.
Encourages employees through recognition of positive changes in behavior.
Tries to ensure employees are ready to move to the next level.
Develops employees by offering and encouraging them to take on new or additional responsibilities.
Others	Agree	Unsure	Disagree	N/A
Works effectively with people from other departments.
Forms working relationships with employees from other departments.
Constructively receives criticism and suggestions from others.
Consistently demonstrates ability and willingness to trust others.
Respects the opinions of other employees.
Global Perspective	Agree	Unsure	Disagree	N/A
Communicates effectively on a multi-lingual basis.
Comfortable using teleconferencing equipment to facilitate meetings with others abroad.
Considers customers point of view when making decisions.
Understands how cultures differ and how these differences impact work behavior.
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.