Safety - 360 Degree Feedback Survey Sample #14

360 Feedback Survey

Instructions

Our company is excited to introduce a new web-based survey tool designed to gather comprehensive feedback on core competencies and role responsibilities critical to the ongoing success of our organization. The Leadership Team Members have unanimously agreed to participate in this initiative and are actively seeking your valuable feedback.

In this context, you have been specifically selected to provide insights on the manager listed above. Your feedback is a crucial component of our company's leadership development process. This tool is intended to capture broad and detailed feedback on the essential competencies and responsibilities that underpin our organization's sustained success and growth.

Your thoughtful and candid responses will play a significant role in guiding the professional development of our leadership team. By reflecting on your experiences and interactions with the manager over the past six to twelve months, you will help us identify strengths, areas for improvement, and opportunities for growth. Your feedback will be combined with that of others and presented to the manager to support their ongoing development. Rest assured, your comments will be shared anonymously, ensuring your privacy while contributing to a culture of continuous improvement and excellence.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve (12) months. Your responses will be merged with other people's feedback and presented to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager, unless you indicate otherwise.

You are only being asked to rate 8 competencies. Each competency will have a variety of statements that are grouped by 4 Performance Levels. Click on the level that best describes this individual.

Please ensure that your submission is made between .

Safety	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Mitigates hazards and safety issues that arise.
Develops a culture of safety.
Participates in safety training as applicable.
Participates in safety training when available.
Creates accurate and effective measures of safety.
Participates in safety training when offered.
Encourages others to attend safety training.
Identifies predictable hazards in the workplace.
Supports safety programs and procedures.
If [Participant Name] were to make improvements in Safety, what are your suggestions for how he/she can improve this?
Results Oriented	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Determines what resources will be needed to achieve the objectives.
Concentrates efforts on the most urgent needs.
Views obstacles as opportunities to improve self.
Makes sure employees have the resources they need to achieve their results.
Pursues performance benchmarks despite obstacles and setbacks.
Adapts to disruptions in the supply chain to maintain production levels.
If [Participant Name] were to make improvements in Results Oriented, what are your suggestions for how he/she can improve this?
Collaboration	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Promotes open participation and communication within department and throughout the organization.
Works to create innovative ideas from the collaboration with others.
Encourages teammates to settle their differences and work together.
Creates an environment of open and transparent communication.
Understands that collaboration often leads to more innovative and effective solutions.
Fosters a collaborative work environment where mutual inspiration leads to innovative problem-solving.
If [Participant Name] were to make improvements in Collaboration, what are your suggestions for how he/she can improve this?
Trustworthy	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Works in a way that makes others want to work with her/him.
Demonstrates congruence between statements and actions.
Communicates an understanding of the other person's interests, needs and concerns.
Delivers on promises made.
Is trustworthy; is someone I can trust.
Consistently keeps commitments.
If [Participant Name] were to make improvements in Trustworthy, what are your suggestions for how he/she can improve this?
Company	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Impresses upon others the important aspects of [Company].
Follows existing procedures and processes.
Understands the use of [Company] products and services.
Understands the "basics" as to how [Company] functions/operates.
Understands how decisions impact other business units beyond their immediate department of work group.
Attends [Company] gatherings and social events.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?
Leadership	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Highly effective supervisor.
Effectively leads others.
Able to influence others.
Motivates others to reach and exceed organizational goals and objectives.
Takes ownership and accountability for results
Gives direct, constructive, and actionable feedback.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?
Problem Solving	Needs Improvement	Could Benefit from Development	Performs as Expected	Is a Role Model for Others	Don't Know
Able to balance the needs of different people in a solution to a problem.
Makes judgments based upon relevant information.
Identifies fresh approaches and shows a willingness to question traditional assumptions.
Is a good problem solver and decision maker
Finds creative ways to get things done with limited resources.
Actively seeks the root cause of a problem.
If [Participant Name] were to make improvements in Problem Solving, what are your suggestions for how he/she can improve this?

46. Strengths
    
    
    
47. Areas for Development
    
    
    
48. Please give any final comments or suggestions for [Participant Name Here]'s assessment.