Safety - 360 Degree Feedback Survey Sample #11

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.

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 are aware of osha safety guidelines.
• You participate in safety training as applicable.
• You support our company's safety programs.
• You are not afraid to question a potential safety issue observed in the workplace.
• You ensure compliance with safety regulations.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Passion To Learn

What does Passion To Learn mean?
It means that ...

• You are committed to enhancing your own knowledge and skills.
• You stay up-to-date on emerging technologies.
• You recognize own areas for development and consciously seek assignments that will provide practice in areas of developmental need.
• You enhance your value to the company through additional training and development.
• You take advantage of training opportunities when they arise.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Project Management

What does Project Management mean?
It means that ...

• You are able to adjust project schedule as needed to accommodate unforeseen issues.
• You work with customers and clients to assess their needs and define project parameters.
• You respond quickly and appropriately to unforeseen problems.
• You define project outcomes based on customer requirements.
• You maintain costs and expenses within budget limits.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Technical

What does Technical mean?
It means that ...

• You use expertise to identify issues and think through creative solutions to get a problem solved or objective accomplished.
• You seek information from others as needed.
• You demonstrate mastery of the technical competencies required in your work.
• You keep current with technical advances within your professional discipline; embrace and apply new techniques and practices
• 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.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Partnering/Networking

What does Partnering/Networking mean?
It means that ...

• You maintain infrastructure to support partnerships and networks.
• You support and encourage relationships that are created by diverse team members.
• You create value within the Company by building networks.
• You build alliances between departments and teams.
• You seek an understanding of diverse functions within the Company.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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