Safety - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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

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Safety

• Encourages others to attend safety training.
• Develops a sustainable safety culture.
• Encourages others to work safely.
• Committed to safety in the workplace.
• Seeks to reduce the likelihood of accidents.

If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?

Customer Focus

• Is aware of the customer's needs.
• Interacts with customers to define roles, expectations, and responsibilities.
• Sets an example for excellent customer relations.
• Is aware of expectations from customers.
• Is pro-active in dealing with customers and addressing their needs.

If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?

Strategic Insight

• Communicates with employees to find out their needs.
• Implements long-term solutions to problems.
• Maintains knowledge of current trends in the industry.
• Allocates proper resources for employee training to meet future needs based on insight into employee skill levels.
• Pursues strategic alliances with valued partners.

If [Participant Name] were to make improvements in Strategic Insight, what are your suggestions for how he/she can improve this?

Accountability

• Is someone you can trust.
• Aware of the consequences for failure to complete the project.
• Always starts work on time.
• Requires employees to submit monthly reports of the work they performed.
• Expects employees to account for their actions and performance.

If [Participant Name] were to make improvements in Accountability, what are your suggestions for how he/she can improve this?

Initiative

• Does things without being told.
• Updates the documentation as soon as the situation changes.
• Coach others to foster an environment which can adapt quickly and willingly to rapid change.
• Acts quickly to address any issues or problems.
• Acts on own initiative to improve the department outcomes.

If [Participant Name] were to make improvements in Initiative, what are your suggestions for how he/she can improve this?

Overall, please rate the effectiveness of [Participant Name Here].

5- Very Effective 4- Effective 3- Neither 2- Ineffective 1- Very Ineffective

Strengths


Areas for Development


Please give any final comments or suggestions for [Participant Name Here]'s assessment.