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
Is aware of OSHA safety guidelines.
Encourages others to work safely.
Seeks to reduce the likelihood of accidents.
Develops a sustainable safety culture.
Committed to safety in the workplace.
Participates in safety training when offered.
Keeps accurate safety records.
Identifies and addresses safety needs.
Mitigates hazards and safety issues that arise.
Collaboration	Strongly Disagree	Disagree	Agree	Strongly Agree
Builds consensus among partners.
Uses effective strategies to re-engage team members and secure their commitment to the business's common good.
Integrates digital tools to streamline the collaborative processes of Research and Development.
Ensures relevant data is available to all committee members.
Collaborates to manage interpersonal disputes with a positive approach.
Conflict Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Uses conflict as a springboard for leadership development, helping individuals grow in resilience, empathy, and influence.
Ensures fair treatment for both parties, giving each the chance to speak and share their viewpoints.
Synthesizes input from multiple stakeholders to form a coherent understanding of the conflict landscape.
Establishes roles and responsibilities.
Addresses concerns about the availability of limited resources.
Others	Strongly Disagree	Disagree	Agree	Strongly Agree
...treats others with respect and dignity.
Constructively receives criticism and suggestions from others.
Respects the opinions of other employees.
Treats others with respect and dignity.
Helpful
Integrity	Strongly Disagree	Disagree	Agree	Strongly Agree
Keeps confidential information secure and respects the privacy of team members.
Always conducts themselves in an honest and upfront manner
Is upfront, truthful, and sincere in all dealings with others.
Demonstrates consistency in actions and values based on core principles and beliefs.
Aspires to high organizational principles to build a firm ethical culture.
Decision Making	Strongly Disagree	Disagree	Agree	Strongly Agree
Carefully evaluates information before making an important decision.
Understands what factors are important for deciding if a decision is "worth it"?
Tests proposed solutions to confirm they meet essential parameters before implementation.
Decision making involves careful analysis of the facts and consideration of parameters and constraints.
Outlines the parameters influencing the decision making process.
Change Management	Strongly Disagree	Disagree	Agree	Strongly Agree
Encourages staff to adapt to the new methods and procedures.
Develops a proactive strategy to manage changes happening in the business environment.
Is aware of changes in customer needs/demands.
Forms an effective change management team.
Understands the consequences that may result from significant changes.
Excellence	Strongly Disagree	Disagree	Agree	Strongly Agree
Keeps themselves and others focused on constant improvement.
Can be counted on to add value wherever they are involved.
Takes a lot of pride in their work.
Is planful and organized.
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.