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.

Safety	Definite Strength	Meets Standards	Needs Development	N/A
You participate in safety training as applicable.
You mitigate hazards and safety issues that arise.
You develop a strong safety culture.
You perform work safely.
You are committed to safety in the workplace.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You are open to change and adjusts plans when needed.
You are flexible and open to new ideas and encourages others to recognize the value of change.
You will stop what you are doing to help colleagues in need.
You can take on new assignments.
You are effective in working with different personnel of the team.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You keep yourself up-to-date of technical/professional issues
You quickly acquire and apply new knowledge and skills when needed
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You allow employees to fully participate in employee training and professional development.
You seek opportunities for continuous learning.
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
You avoid referring to stereotypes about others from different cultures.
You communicate with others without the influence of racism.
I recognize individual and cultural differences.
You understand how implicit biases can affect decisions, communication and productivity.
You encourage a work environment where individual differences are valued.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You set clear and reasonable expectations for others and follow through on their progress.
You clearly define duties and tasks to be completed.
You define the roles, responsibilities, required actions, and deadlines for team members.
You delegate authority and responsibility to subordinates and holds them accountable for your actions.
You encourage and empower subordinates to use initiative in achieving goals and objectives.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
I have enough self-control to avoid making impulsive decisions.
You decide which long-term goals should be met.
I consider the ethical implications of decisions.
You come across as confident, decisive, and resilient
You recognize and generates innovative solutions.
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
I inspire others to accept changes.
I am a leading force driving changes.
I develop strategies for implementing changes.
I inspire others to accept the recent changes.
I am able to get department employees to accept new changes.
Technical	Definite Strength	Meets Standards	Needs Development	N/A
You willingly share your technical expertise; sought out as resource by others
You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
You are knowledgeable of procedures or systems necessary for the job.
You know how to produce high quality products/work.
You willingly share information and expertise; sought out as resource by others
Client Focus	Definite Strength	Meets Standards	Needs Development	N/A
You thoroughly understand the needs of the client.
I am competent in managing client projects.
I respond to the needs of the client.
I am persistent in solving client issues.
I prioritize client issues based on urgency.
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You coach team members
You foster respect and understanding among team members
I ask other team members to share their opinions.
You are an effective team player
You seek and listen to other's contributions
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You understand departmental policies and procedures.
You are able to use corporate politics to advance department objectives.
You anticipate problems that may affect the department.
You are able to deal with sensitive issues with tact and professionalism.
You are effective in communicating with others within the organization.

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.