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 encourage others to work safely.
You commit adequate resources toward safety measures.
You create accurate and effective measures of safety.
You are committed to safety in the workplace.
You encourage others to attend safety training.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You adjust strategy when new information is presented.
You adapt to diversity within the team.
You work effectively with various personalities of team members.
You are able to adjusts tactics when things are not working as expected.
You are able to adjust to changes as needed.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You encourage employees to take courses relevant to their job.
You seek opportunities for professional development.
You quickly acquire and apply new knowledge and skills when needed
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You keep yourself up-to-date of technical/professional issues
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
I am aware of my cultural views.
I seek knowledge and information about other cultures.
I value the diverse perspectives from others.
You recognize and value individual and cultural differences.
I seek clarification to avoid misunderstandings.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You clearly define duties and tasks to be completed.
You tell subordinates what to do, not how to do it.
You delegate tasks, responsibilities, and accountability as appropriate to the level of employee.
You allow employees to decide how they wish to complete the tasks.
You define the roles, responsibilities, required actions, and deadlines for team members.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I am able to learn from my mistakes.
You weigh the pros and cons of decisions.
You are willing to change your strategy if new information arises.
You come across as confident, decisive, and resilient
I examine for patterns in data to help predict future possibilities.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
I inspire others to accept changes.
You adopt changes to set and example for others to follow.
I develop strategies for implementing changes.
I inspire others to accept the recent changes.
You support the Company's efforts to implement changes.
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 seek information from others as needed.
You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
You know how to produce high quality products/work.
You demonstrate mastery of the technical competencies required in your work.
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You deliver high quality products to the client.
You get feedback from the client on a weekly basis.
I am available to respond to client needs.
You provide a high level of service to clients.
I am aware of expectations from clients.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You encourage teamwork and collaboration.
You actively and openly participates in group meetings.
You relate to all kinds of people tactfully
You come across as a reliable, committed team member
You foster respect and understanding among team members
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You are adept at navigating within the culture of the department.
You are effective in communicating with others within the organization.
You are aware of other organizational cultures to compare/contrast with the current organizational culture.
You understand departmental policies and procedures.
You anticipate problems that may affect 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.