Safety - Employee Opinion Survey Sample #1





Surveys Measuring Safety:
Example 1 (5-point scale; numbers; NA)
Example 2 (7-point scale; radio buttons)
Example 3 (4-point scale; radio buttons)
Example 4 (5-point scale; radio buttons)
Example 5 (5-point scale; words)
Example 6 (Pulse Survey)
Example 7 (5-point scale; item comments)
Example 8 (3-point scale; words; N/A)
Example 9 (4-point scale; numbers)
Example 10 (Comment boxes only)
Example 11 (Single rating per dimension)
Example 12 (Slide-bar scale)
Dear Employee:


Welcome to the Employee Opinion Survey. We recognize that our employees are our biggest asset and we are committed to continuing to ensure that the [Company] is considered a great place to work. We would like to hear from you as your opinions will help to guide our objectives.

We have developed this survey with questions tailored for our staff and business to provide you with an opportunity to anonymously rate many facets of the business. The survey will assess what you value most in your employment and allow you to make positive suggestions for improvement.

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

Dimensions Included:
Safety, Communication, Feedback/Guidance, Job Satisfaction, Flexibility, Training, Leadership, Company, Resources, Wellness Program


Instructions:
Please complete the items below and press the submit button at the end of the survey. If you need multiple sessions to complete the survey, please click the "Submit" button at the end of each session to save your responses. Please feel free to skip any items that you do not wish to respond to. Keep in mind that your responses help us to become a better place to work. So, you are encouraged to respond to all items on the questionnaire.




Safety

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. Managers regularly meet with employees to discuss safety issues
  1. I know what to do in an emergency situation
  1. My manager does not compromise on safety
  1. My Supervisor would not ask me to perform an unsafe procedure
  1. The safety and health conditions where I work are good
If [Participant Name] were to make improvements in Safety, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Communication

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I know how to communicates effectively with management, both upward and downward
  1. Sales reps set their on-line status to "available" to indicate they are available for communication.
  1. HR Managers will listen to both side in employer/employee disputes
  1. Managers rspond in a timely manner, respecting deadlines and others' schedules
  1. The supervisor implements performance appraisals focused on employee development using SMART criteria
If [Participant Name] were to make improvements in Communication, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Feedback/Guidance

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I receive adequate feedback and guidance.
  1. I am comfortable giving feedback to others.
  1. I actively seek feedback from colleagues and customers about my work.
  1. I see my role to include mentoring and coaching others.
  1. I receive mentoring and coaching from my superior.
If [Participant Name] were to make improvements in Feedback/Guidance, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Job Satisfaction

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I am proud to tell others I work for the Company
  1. I receive a lot of satisfaction from my job
  1. The people in my department feel good about coming to work
  1. Considering everything, I am satisfied at this Company
  1. My job is rewarding
If [Participant Name] were to make improvements in Job Satisfaction, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Flexibility

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. The supervisor is able to quickly recover from setbacks.
  1. The team leader can seamlessly transition between various environments and situations.
  1. Supervisors integrate new ideas and information into solutions and processes.
  1. Coworkers are resilient and proactive to help thrive in unpredictable environments.
  1. The supervisor is capable of adapting workflows to accommodate new regulations or policies.
If [Participant Name] were to make improvements in Flexibility, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Training

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. The training I receive is relevant to my job
  1. I feel I am well prepared and have the tools to succeed in my role as an associate, supervisor, manager, or top leader.
  1. Training is offered at times convenient to me
  1. I have received good training to do my job
  1. The Company supports efforts by employees to obtain training on new skills
If [Participant Name] were to make improvements in Training, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Leadership

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. Leadership is able to implement ideas and suggestions.
  1. Leadership at the Company encourages initiative and risk taking
  1. The Leadership helps maximize business results
  1. Leaders are open to feedback from multiple perspectives
  1. Leaders identify problems, collect information from various sources, and synthesize that information into effective solutions
If [Participant Name] were to make improvements in Leadership, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Company

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. Morale at CompanyName is high.
  1. This company is committed to providing competitive products and services.
  1. CompanyName is an ethical company.
  1. Our standards for business ethics are high.
  1. I am motivated to see the company succeed.
If [Participant Name] were to make improvements in Company, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Resources

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. I understand the budget process
  1. I can manage information and technical resources to achieve objectives
  1. I have all the tools and equipment I need to do my job well
  1. My Supervisor is effective in maximizing the potential of others
  1. My workplace is a physically comfortable place to work
If [Participant Name] were to make improvements in Resources, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?

Wellness Program

Strongly
Disagree
1
2
Neutral
3
4
Strongly
Agree
5
Not
Applicable
  1. The Company wellness program is easy to use
  1. I feel confident in using the wellness program
  1. The wellness program is convenient for me
  1. I feel the wellness program is an excellent support resource for employees
  1. The Company wellness program is personal and confidential
If [Participant Name] were to make improvements in Wellness Program, which item do you think should be emphasized most over the next two years in order to make us a more effective organization. Type the number here: What are your suggestions for how we can improve this?




  1. What changes would you like to see in your benefit plans? Please note that some of these may increase premium rates. Please check all that apply.
    Add a higher deductible plan ($1,000 - $2,500)
    Increase vision care
    Increase dental care
    Add wellness program (weight loss, nutrition, smoking cessation programs, etc.)
    Add a Medical Spending Account (MSA) (allows employees to enroll in a high deductible health plan,
    spacer and then [Company] and the employee contribute on a pre-tax basis to an account used for eligible medical expenses)


  2. What changes would you be willing to accept in order to help hold down premium increases? Please check all that apply.
    Higher annual deductibles (the amount you pay out-of-pocket before benefits begin)
    Higher office visit co pays (the dollar amount you pay for office visits)
    Higher prescription drug co pays (the dollar amount you pay for prescription drugs)
    More network restrictions (smaller group of doctors and specialists to choose from)
    No dental coverage
    Other, please specify


  3. How often would you like to participate in after hours company event?






  4. How would you rate your satisfaction with the communication between you and [Company]?







  5. What would you change about your current job or position?


  6. Please identify factors that would improve your job performance in the coming year.


  7. When your performance was discussed with you in the past,
    how often did you receive practical suggestions for improving your work?






  8. How would you rate your overall satisfaction with the company in the past year?






  9. Please give any comments or suggestions on how the company can be improved in the coming year: