Safety - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Self-Assessment Instructions

Thank you for agreeing to participate in this leadership training process. As part of this process, you will be completing the self-assessment questionnaire (below). As you respond, please draw on your work experiences over the past 12 months. Rate each item using the scale shown. Comments at the end can help you to explain your ratings. If you gave a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to you at the next leadership seminar to help guide your ongoing professional development.

You can save your progress on partially completed forms by clicking the Save/Still Working button located at the bottom of the page. This allows you to come back at a later time to finish or make any necessary edits to the form. When you return, your previously saved responses will automatically be displayed, allowing you to seamlessly continue where you left off. When you have completed filling out the form and are confident that no further changes are needed, please click the Complete button.

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Safety	Definite Strength	Meets Standards	Needs Development	N/A
You identify and addresses safety needs.
You develop safety guidelines for the department.
You develop a culture of safety.
You participate in safety training when offered.
You are aware of osha safety guidelines.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You are able to adjusts tactics when things are not working as expected.
You analyze situations quickly to determine most pressing needs and possible solutions.
You are aware of changes to the policies and procedures.
You handle changes easily.
You are able to adjust to new plans and procedures.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You seek opportunities for professional development.
You seek opportunities for continuous learning.
You encourage employees to take courses relevant to their job.
You keep yourself up-to-date of technical/professional issues
You allow employees to fully participate in employee training and professional development.
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
I am aware of differences in how individuals from other cultures greet one another.
I promote culturally respectful partnerships with external stakeholders and global teams.
I publicly acknowledge cultural contributions and achievements in team settings.
You recognize and value individual and cultural differences.
I create safe spaces for employees to share cultural perspectives and experiences.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You optimize how tasks are distributed.
You discuss new task assignments during one-on-one meetings.
I take into account an employee's technical skills, soft skills, experience, and industry knowledge.
You assign challenging responsibilities to boost employee professional development while maintaining engagement.
You tell subordinates what to do, not how to do it.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I make clear what is in scope and out of scope to avoid misalignment or unrealistic expectations.
You make decisions based on novel interpretations of the facts.
You build decisions with contingency plans and modular thinking to accommodate future change.
You are aware of the impact of decisions and informs others about potential outcomes.
I understand when gut instinct is helpful and when it needs to be supplement with evidence.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
I remove obstacles and hurdles that might impede change.
I involve senior employees in implementation of the changes.
I help employees overcome their resistance to change.
I mobilize resources need to implement the changes.
You use customer feedback to determine the changes need to maintain profitability.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You are knowledgeable of procedures or systems necessary for the job.
You willingly share information and expertise; sought out as resource by others
You willingly share your technical expertise; sought out as resource by others
You demonstrate mastery of the technical competencies required in your work.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You create innovative solutions to meet client needs.
I am focused on improving client services.
You follow up with any unanswered questions from the client.
You are honest in all communication with the clients.
I tailor innovative products for each client.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You provide assistance and support to other team members when needed
I express appreciation for the work of other team members.
You encourage dialog between team members.
I ask other team members to share their opinions.
You demonstrate an understanding of other team member's viewpoints.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You anticipate problems that may affect the department.
You are able to deal with sensitive issues with tact and professionalism.
You are able to explain departmental policies and procedures to others.
You are able to use corporate politics to advance department objectives.
You are aware of other organizational cultures to compare/contrast with the current organizational culture.

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

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

    
    
57. Strengths
    
    
    
58. Areas for Development
    
    
    
59. Please give any final comments or suggestions for [Participant Name Here]'s assessment.