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.

Edit this Survey

Would you like to edit this survey? Click here to begin.

Safety	Definite Strength	Meets Standards	Needs Development	N/A
You evaluate whether existing controls are adequate and update them when risks change.
I integrate recognized best practices into the design and operation of safety programs.
You encourage others to attend safety training.
You keep accurate safety records.
You communicate the importance of disaster readiness and reinforce expectations for preparedness.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You implement new rules, procedures, or regulations.
You continually try to improve skills to remain current.
You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
You are able to adjust to changing environments.
You adapt to novel, dynamic, and changing situations requiring creative solutions to new problems.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You seek opportunities for professional development.
You seek opportunities for continuous learning.
You keep yourself up-to-date of technical/professional issues
You quickly acquire and apply new knowledge and skills when needed
You allow employees to fully participate in employee training and professional development.
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
You understand how your own cultural background can impact the way you communicate and interact with others.
You participate in diversity and inclusion initiatives to model respectful engagement.
I promote continuous learning about customs, traditions, and workplace etiquette.
You are sensitive to the similarities and differences that exist between cultures.
I recognize individual and cultural differences.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
I offer constructive feedback and recognize achievements.
You recognize individual expertise to delegate tasks in a way that maximizes team performance and workflow efficiency.
You entrust employees with tasks that reflect their core proficiencies, fostering accountability and confidence.
You clearly define tasks for employees.
I offer work that aligns with career aspirations.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I know when to delegate, collaborate, or pause based on an assessment of my capabilities or expertise.
You are aware of the impact of decisions and informs others about potential outcomes.
You understand how different perspectives can help make better informed decisions.
You use reasonable assumptions and logic to decide between alternate courses of action
You question entrenched beliefs or norms that may limit creativity or hinder progress.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
You recognize employees who facilitate the organization making progress on the necessary changes.
I introduce structural changes to the team/department.
You are able to work effectively in new environments, with new team members in uncertain environments.
You support various change management activities.
I facilitate and lead the change management process.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You know how to produce high quality products/work.
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 willingly share information and expertise; sought out as resource by others
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.
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You put client's needs first.
You help others in responding to client needs.
I keep the client informed of all progress.
I exceed expectations of the clients.
You make sure your interests are aligned with the client's interests.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
I encourage other team members to adopt new procedures.
I make decisions that support the team's goals and objectives.
I establish good rapport with team members.
I consider the impact and implications of decisions on the team.
You create a climate that encourages team participation.
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You are aware of other organizational cultures to compare/contrast with the current organizational culture.
You are effective in communicating with others within the organization.
You anticipate problems that may affect the department.
You are adept at navigating within the culture of the department.
You are able to explain departmental policies and procedures to others.

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.