Safety - 360 Degree Feedback Survey Sample #13

Instructions

You are being requested to provide valuable feedback on the manager listed above. Your insights and observations are a crucial element in our continuous efforts to enhance our performance through this leadership development program. This feedback tool has been carefully designed to gather detailed and comprehensive input on the core competencies and role responsibilities that are integral to the ongoing success and growth of our organization.

We believe that your unique perspective, based on your interactions and experiences with this manager, will contribute significantly to identifying strengths, areas for improvement, and opportunities for professional growth. Your feedback will help us foster a culture of excellence, accountability, and continuous improvement within our leadership team.

As you complete the assessment form, please reflect on your interactions with this individual over the past six to twelve months. Your responses will be combined with feedback from others and presented to the manager to aid in their ongoing development. Rest assured, your comments will be shared anonymously, exactly as you write them.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.



Please complete your response by .

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Safety	Strongly Disagree	Disagree	Agree	Strongly Agree
Works to implement corrective safety measures.
Ensures compliance with safety regulations.
Is not afraid to question a potential safety issue observed in the workplace.
Encourages others to work safely.
Supports our company's safety programs.
Ensures that all supervisors are aware of regulatory and compliance measures.
Creates accurate and effective measures of safety.
Performs work safely.
Develops safety guidelines for the department.
Collaboration	Strongly Disagree	Disagree	Agree	Strongly Agree
Open to feedback and willing to share insights to foster a collaborative work environment where everyone feels empowered to contribute.
Willing to work with others to solve problems.
Respectful of others in group discussions.
Engages in consensus-building activities.
Has the confidence and trust of other partners.
Conflict Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Addresses contentious issues earlier rather than later.
Facilitates dialog between stakeholders.
Removes misperceptions that may be contributing to the conflict.
Able to persuade and influence others.
Steers the process towards compromise and conflict resolution.
Others	Strongly Disagree	Disagree	Agree	Strongly Agree
Respects the opinions of other employees.
Works across boundaries within the organization.
Includes others in the decision making processes.
Constructively receives criticism and suggestions from others.
Able to see issues from others' perspectives.
Integrity	Strongly Disagree	Disagree	Agree	Strongly Agree
Follows tasks to completion.
Fosters a high standard of ethics and integrity.
Establishes relationships of trust, honesty, fairness, and integrity.
Protects the integrity and confidentiality of information
Fosters an environment built upon trust.
Decision Making	Strongly Disagree	Disagree	Agree	Strongly Agree
Outlines the parameters influencing the decision making process.
Is able to make decisions quickly.
Determines the costs and potential benefits of decisions.
Defines what constraints must be met for the decision making process.
Asks for additional information when making critical decisions.
Change Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Is a leading force driving changes.
Inspires others to want to change.
Adopts changes to set and example for others to follow.
Supports new initiatives for organizational changes to improve effectiveness.
Inspires others to accept changes.
Excellence	Strongly Disagree	Disagree	Agree	Strongly Agree
Takes a lot of pride in their work.
Keeps themselves and others focused on constant improvement.
Is planful and organized.
Demonstrates the analytical skills to do their job.
Demonstrates the functional or technical skills necessary to do their job.

45. Describe the greatest strengths of this person with regard to his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
46. Describe the most important things this person could improve upon in order to increase his/her overall effectiveness in performing his/her current responsibilities.
    
    
    
47. Overall, please rate the effectiveness of [Participant Name Here].
    

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

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