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 participate in safety training as applicable.
You develop a sustainable safety culture.
You encourage others to attend safety training.
You support safety programs and procedures.
You participate in safety training when available.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You are aware of changes in the environment.
You learn from personal experiences and/or mistakes.
You are open to change and adjusts plans when needed.
You perform a wide range of tasks, respond to changes in direction and priorities and accept new challenges, responsibilities, and assignments.
You are effective in working with different personnel of the team.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You are contributing fully to the extent of your skills
You allow employees to fully participate in employee training and professional development.
You seek opportunities for continuous learning.
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 am aware of cultural differences in business etiquette.
You engage with individuals that have different cultural backgrounds.
You acknowledge your own biases in cultural interactions.
I help other employees to become more culturally sensitive.
You support and mentor others that may have different cultural backgrounds.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You define goals and objectives for subordinates.
You define the roles, responsibilities, required actions, and deadlines for team members.
You allow subordinates to use their own methods and procedures.
You entrust subordinates with important tasks.
You assign tasks to create learning opportunities for the employees.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I examine for patterns in data to help predict future possibilities.
I am open to listening to others who may have different ideas.
You break complex issues into manageable parts and organize them in a systematic way before making decisions
You view the long and short-term impact of decisions.
I decide which short- and long-term goals should be created.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
I am a leading force driving changes.
You support the Company's efforts to implement changes.
You are effective in dealing with ambiguous and challenging situations.
I am able to get team members to change their attitudes.
You adopt changes to set and example for others to follow.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You are knowledgeable of procedures or systems necessary for the job.
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 willingly share information and expertise; sought out as resource by others
You know how to produce high quality products/work.
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You prioritize the needs and preferences of the client.
You help clients feel they are receiving services tailored specifically to their needs.
I am aware of expectations from clients.
I create an environment that enables clients to receive excellent service.
You deliver high quality products to the client.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
I work with other team members to identify bottle necks in the production process.
You communicate a clear message that teamwork and collaboration are expected.
You encourage teamwork and collaboration.
I establish good rapport with team members.
You create a culture that fosters and values collaboration.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You are able to deal with sensitive issues with tact and professionalism.
You are able to use corporate politics to advance department objectives.
You anticipate problems that may affect the department.
You are effective in communicating with others within the organization.
You get things done through the department.

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.