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 keep accurate safety records.
You support our company's safety programs.
You seek to reduce the likelihood of accidents.
You develop safety guidelines for the department.
You ensure that all supervisors are aware of regulatory and compliance measures.
Adaptability	Definite Strength	Meets Standards	Needs Development	N/A
You adjust priorities to changing business goals.
You learn from personal experiences and/or mistakes.
You are able to quickly learn new ways of performing your job.
You are flexible and open minded in dealing with others.
You are flexible and open to new ideas and encourages others to value change.
Professional Development	Definite Strength	Meets Standards	Needs Development	N/A
You seek opportunities for professional development.
You demonstrate enthusiasm and a willingness to learn new skills and knowledge
You are contributing fully to the extent of your skills
You seek opportunities for continuous learning.
You encourage employees to take courses relevant to their job.
Cultural Awareness	Definite Strength	Meets Standards	Needs Development	N/A
You foster a diverse workforce free from discrimination and harassment.
You treat others with dignity and respect.
You show respect in daily interactions
You value the opinions of diverse groups and individual.
You recognize and value individual and cultural differences.
Delegation	Definite Strength	Meets Standards	Needs Development	N/A
You tell subordinates what to do, not how to do it.
You define goals and objectives for subordinates.
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 clearly define duties and tasks to be completed.
Decision Making	Definite Strength	Meets Standards	Needs Development	N/A
You exercise good judgment by making sound and informed decisions.
You break complex issues into manageable parts and organize them in a systematic way before making decisions
You ask for additional information when making critical decisions.
You are able to make decisions quickly.
You do not lose sight of the big picture when making decisions
Change Management	Definite Strength	Meets Standards	Needs Development	N/A
You support the Company's efforts to implement changes.
You support new initiatives for organizational changes to improve effectiveness.
You assist others in understanding changes to the organization.
You are effective in implementing new organizational vision and values.
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 willingly share your technical expertise; sought out as resource by others
You seek information from others as needed.
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 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 look for opportunities that have a positive impact on Clients.
You maintain strong relationships with clients.
You obtain feedback to ensure client needs are being met.
You are pro-active in dealing with clients and addressing your needs.
You ensure client commitments and requirements are met or exceeded
Teamwork	Definite Strength	Meets Standards	Needs Development	N/A
You create opportunities to learn with other team members
You share credit for accomplishments with team members
You build relationships across boundaries and with key stakeholders by developing informal and formal networks.
You contribute to and supports team decision-making process
You foster respect and understanding among team members
Organizational Fluency	Definite Strength	Meets Standards	Needs Development	N/A
You adept at navigating within the culture of the department.
You understand departmental policies and procedures.
You understand the current organizational culture.
You are effective in communicating with others within the organization.
You are able to deal with sensitive issues with tact and professionalism.

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.