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.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.

Safety	Definite Strength	Meets Standards	Needs Development	N/A
You ensure compliance with safety regulations.
You mitigate hazards and safety issues that arise.
You participate in safety training as applicable.
You are not afraid to question a potential safety issue observed in the workplace.
You seek to reduce the likelihood of accidents.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You recognize and implement changes to enhance efficiency and effectiveness.
You are effective in working with different personnel of the team.
You are able to work effectively with new people and new teams.
You are aware of changes to the policies and procedures.
You can accommodate changes as needed.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You seek opportunities for professional development.
You encourage employees to take courses relevant to their job.
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You quickly acquire and apply new knowledge and skills when needed
You keep yourself up-to-date of technical/professional issues
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
I help other employees to become more culturally sensitive.
I actively listen to other employees' stories about their culture.
You acknowledge your own biases in cultural interactions.
I participate in cultural training sessions/classes.
I interact effectively with people from different cultural backgrounds.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You tell subordinates what to do, not how to do it.
You allow employees to decide how they wish to complete the tasks.
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
You delegate authority and responsibility to subordinates and holds them accountable for your actions.
You entrust subordinates with important tasks.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
You remain focused on the immediate goal when making decisions.
You maintain focus on the "big picture" when making decisions.
I am able to learn from my mistakes.
You are open to the suggestions from subordinates.
You outline the parameters influencing the decision making process.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
You are effective in implementing new organizational vision and values.
I facilitate change with minimal resistance.
I develop plans for following through on the changes.
I inspire others to accept changes.
You adopt changes to set and example for others to follow.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You are naturally sought out by people outside your particular area for advice and opinion on a broad range of matters - not necessarily solely legal advice.
You demonstrate mastery of the technical competencies required in your work.
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You willingly share information and expertise; sought out as resource by others
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
I respond to the needs of the client.
I prioritize client issues based on urgency.
I am transparent in all communications with the client.
You deliver high quality products to the client.
You focus on the unique needs of each client.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You contribute to and supports team decision-making process
You share credit for accomplishments with team members
You work cooperatively with others to solve problems.
You coach team on how to solve problems, plan, and meet organizational goals and objectives.
I help the team make good decisions even under conditions of uncertainty.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You understand the current organizational culture.
You are able to use corporate politics to advance department objectives.
You are able to deal with sensitive issues with tact and professionalism.
You understand departmental policies and procedures.
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.