Safety - 360 Degree Feedback Survey Sample #11





360 Feedback Survey

Questionnaires Measuring Safety:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)
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.

Competencies Included:
Safety, Passion To Learn, Project Management, Technical, Partnering/Networking
Sample Result Document:
Sample Results
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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


Safety

What does Safety mean?
It means that ...
  • You perform work safely.
  • You are not afraid to question a potential safety issue observed in the workplace.
  • You create accurate and effective measures of safety.
  • You ensure compliance with safety regulations.
  • You point out behaviors in others that may be unsafe.

To what extent does this person exhibit Safety?
Select from one of the ratings below.

Passion To Learn

What does Passion To Learn mean?
It means that ...
  • You take advantage of training opportunities when they arise.
  • You create an environment that supports personal development and exploration.
  • You hold self and associates accountable for goal achievement.
  • You exhibit willingness to upgrade skills through additional training and education.
  • You constantly enhance product knowledge through experimentation and play.

To what extent does this person exhibit Passion To Learn?
Select from one of the ratings below.

Project Management

What does Project Management mean?
It means that ...
  • I identify the project time and budget constraints.
  • I map out the project, timeline, resource requirements, metrics and communication.
  • You respond quickly and appropriately to unforeseen problems.
  • You have detailed knowledge about the project and can adapt the project plan as needed.
  • I keep stakeholders informed of progress on the project.

To what extent does this person exhibit Project Management?
Select from one of the ratings below.

Technical

What does Technical mean?
It means that ...
  • You willingly share information and expertise; sought out as resource by others
  • You are knowledgeable of procedures or systems necessary for the job.
  • You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
  • You know how to produce high quality products/work.
  • You willingly share your technical expertise; sought out as resource by others

To what extent does this person exhibit Technical?
Select from one of the ratings below.

Partnering/Networking

What does Partnering/Networking mean?
It means that ...
  • You communicate with others in an open manner.
  • You regularly schedule coffee chats or informal meetups to deepen personal connections.
  • I foster cross-department collaboration, facilitates information sharing, and establishes common objectives.
  • You seek to avoid conflicts by clarifying problems early on and working quickly to resolve those issues.
  • I ensure that lessons learned from the partnership are disseminated and built upon.

To what extent does this person exhibit Partnering/Networking?
Select from one of the ratings below.
Strengths


Areas for Development


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