Safety - 360 Degree Feedback Survey Sample #11

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.

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.

Edit this Survey

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Safety

What does Safety mean?
It means that ...

• You ensure compliance with safety regulations.
• You are aware of osha safety guidelines.
• You participate in safety training when offered.
• You are not afraid to question a potential safety issue observed in the workplace.
• You create accurate and effective measures of safety.

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 stay up-to-date on emerging technologies.
• You are committed to enhancing your own knowledge and skills.
• You hold self and associates accountable for goal achievement.
• You will participate in training classes even if offered outside of normal working hours.
• You take initiative for own learning and development.

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 ...

• I determine the appropriate strategy for mitigating specific risks.
• I ensure the project is executed on time and on budget.
• You plan and implement responses to potential threats to the success of the project.
• You conduct a risk assessment for each phase of the project.
• I motivate the team to meet project deadlines and performance measures.

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

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 share and develop cutting-edge ideas with a network of colleagues, fostering a culture of innovation and continuous improvement.
• I search for a common solution to shared problems or issues.
• You develop a sense of trust in subordinates so they can freely interact and share information with others.
• You establish regular check-ins to ensure alignment and address any emerging issues.
• You forge mutually beneficial relationships between individuals with diverse backgrounds.

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.