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 .

Safety	Strongly Disagree	Disagree	Agree	Strongly Agree
Performs work safely.
Participates in safety training when available.
Participates in safety training when offered.
Seeks to reduce the likelihood of accidents.
Keeps accurate safety records.
Develops a culture of safety.
Works to implement corrective safety measures.
Develops a sustainable safety culture.
Mitigates hazards and safety issues that arise.
Collaboration	Strongly Disagree	Disagree	Agree	Strongly Agree
Fosters a collaborative work environment where everyone feels committed to achieve common goals.
Collaborates with others to resolve conflicts constructively.
Creates an environment to support free exchange of information.
Avoids promoting a hyper competitive culture in favor of a more collaborative one.
Involves others in reaching a consensus during group activities.
Conflict Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Does not let minor issues escalate into major problems.
Is responsive to contentious issues.
Removes misperceptions that may be contributing to the conflict.
Attempts to determine the root sources of grievances.
Assists team members by helping them see the other point of view.
Others	Strongly Disagree	Disagree	Agree	Strongly Agree
Works effectively with people from other departments.
Treats others with respect and dignity.
Constructively receives criticism and suggestions from others.
Works across boundaries within the organization.
Able to see issues from others' perspectives.
Integrity	Strongly Disagree	Disagree	Agree	Strongly Agree
Demonstrates sincerity in actions with others.
Follows tasks to completion.
Protects the integrity and confidentiality of information
Develops trust and confidence from others.
Does what was promised.
Decision Making	Strongly Disagree	Disagree	Agree	Strongly Agree
Decides which long-term goals should be met.
Maintains focus on the "big picture" when making decisions.
Stays focused on the main objective when making decisions.
Outlines the parameters influencing the decision making process.
Is firm in their decision and not easily influenced by the whims of others.
Change Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Effective in implementing new organizational vision and values.
Is a leading force driving changes.
Develops plans for following through on the changes.
Addresses organizational and departmental resistance to changes.
Develops a strategy for implementing changes.
Excellence	Strongly Disagree	Disagree	Agree	Strongly Agree
Can be counted on to add value wherever they are involved.
Takes a lot of pride in their work.
Demonstrates the analytical skills to do their job.
Keeps themselves and others focused on constant improvement.
Produces high quality work.

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.