Safety - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Instructions

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give 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 the recipient to help guide their ongoing 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

• Seeks to reduce the likelihood of accidents.
• Committed to safety in the workplace.
• Identifies predictable hazards in the workplace.
• Ensures compliance with safety regulations.
• Ensures that all supervisors are aware of regulatory and compliance measures.

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

Customer Focus

• Consistently models positive customer service attitudes.
• Is available to respond to customer needs.
• Prioritizes the needs and preferences of the customer.
• Engages with customers on multiple levels.
• Views customer satisfaction as an everyday priority.

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

Strategic Insight

• Creates values statement to ensure all employees are working under the same guiding principles.
• Creates a vision for the organization based on insights gathered from other companies in the industry.
• Creates strategic plans to develop and promote organizational and area strengths, as well as to address weaknesses based on insight from surveys.
• Converses with customers and clients to get a better insight into their personal needs.
• Attends industry conferences to gain further insight into how other companies deal with similar issues.

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

Accountability

• Chooses integrity over convenience.
• Always keeps the supervisor informed of relevant information.
• Accepts accountability for their work.
• Consistently strives to meet high standards of excellence.
• Regularly leads the way when helping the team troubleshoot various issues.

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

Initiative

• Takes on additional tasks without being asked or told to do so.
• Initiates important conversation topics at meetings.
• Takes the initiative to complete tasks ahead of schedule.
• Takes corrective action to address performance deficiencies/issues.
• Builds strong interpersonal relationships upon first meeting.

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.