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 are aware of osha safety guidelines.
You keep accurate safety records.
You are committed to safety in the workplace.
You mitigate hazards and safety issues that arise.
You create accurate and effective measures of safety.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You are able to respond to incidents without stopping the workflow.
You adapt to diversity within the team.
You are open to change and adjusts plans when needed.
You are able to adjusts tactics when things are not working as expected.
You are aware of changes to team personnel.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You keep yourself up-to-date of technical/professional issues
You allow employees to fully participate in employee training and professional development.
You quickly acquire and apply new knowledge and skills when needed
You seek opportunities for continuous learning.
You are contributing fully to the extent of your skills
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
You are aware of the similarities and differences among and between cultural groups.
You respect the views offered by individuals with different cultural backgrounds.
I interact effectively with people from different cultural backgrounds.
You understand the impact that your culture may have on interactions between individuals.
I develop skills and attitudes to bridge cultural differences.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You allow employees to decide how they wish to complete the tasks.
You assign tasks to create learning opportunities for the employees.
You clearly define duties and tasks to be completed.
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
You tell subordinates what to do, not how to do it.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I am able to learn from my mistakes.
You have a good rapport other people which is helpful in making decisions on the team.
I regularly evaluate information before making important decisions.
You assess the risks, benefits, and potential impact of a number of options when deciding a course of action
You are open to the suggestions from subordinates.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
You work cooperatively with others to implement changes.
I develop strategies for implementing changes.
You address organizational and departmental resistance to changes.
I develop plans for following through on the changes.
I facilitate change with minimal resistance.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You willingly share your technical expertise; sought out as resource by others
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 keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You seek information from others as needed.
You know how to produce high quality products/work.
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You deliver on commitments made to clients.
I respond to feedback from clients.
I create an environment that enables clients to receive excellent service.
You adapt to changes proposed by the client.
You manage client accounts with high degree of competence.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
I make sure each team member participates in the task.
You make eye contact when listening to colleagues.
You recognize and respects the contributions and needs of each individual.
You create opportunities to learn with other team members
I help the team balance analysis with decisiveness in making decisions.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You get things done through the department.
You understand the current organizational culture.
You are able to explain departmental policies and procedures to others.
You are effective in communicating with others within the organization.
You understand departmental policies and procedures.

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.