Safety - Employee Survey Sample #8

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 Survey. We are on a journey to create a workplace that encourages success! A critical component of creating this culture is building a business you recognize as being a great place to work and one that provides you with challenge and recognition. We want to build a thriving and successful business that provides motivation and satisfaction. In order to do so we need to assess how we are doing and understand your thoughts, views and feelings.

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.

The survey is web-based, quick and simple to complete which allows fast reporting and analysis. To ensure your anonymity, the survey is being hosted by an external organization. You will not be required to identify yourself. We want to be very clear that we will not be able to attribute this data to any specific individual and it is not our intention to do so.

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

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.


Agree Unsure Disagree N/A
  1. The safety and health conditions where I work are good
  1. Managers regularly meet with employees to discuss safety issues
  1. I know what to do in an emergency situation
  1. My Supervisor would not ask me to perform an unsafe procedure
  1. My manager does not compromise on safety


Agree Unsure Disagree N/A
  1. The company regularly communicates important standards and regulations.
  1. Our department regularly maintains equipment.
  1. The leadership at the Company does a good job managing risks we face.
  1. I feel comfortable reporting issues to management.
  1. The company offers regular training on the risks and regulations that need to be followed.

Problem Solving

Agree Unsure Disagree N/A
  1. Leaders identify problems, collect information from various sources, and synthesize that information into effective solutions
  1. In my job I focus on problem solving instead of fault finding
  1. My team works to simplify problems to make them more manageable
  1. Employees seek to acquire new information and knowledge before deciding on a course of action when problem solving
  1. We resolve issues in our organization without resorting to blame, anger, or retribution.


Agree Unsure Disagree N/A
  1. Resources are coordinated and utilized effectively in my department.
  1. Assessment is part of the planning process to identify organizational weaknesses and develop solutions
  1. The Company has an excellent workforce planning strategy to meet future needs
  1. Leadership gathers data from a variety of sources for use in strategic planning
  1. Resources are organized and coordinated effectively


Agree Unsure Disagree N/A
  1. I feel this is a good place to work.
  1. I feel like I contribute to the Company.
  1. This organization actively contributes to the community.
  1. I am glad I chose to work at this Company.
  1. The Company is a good employer to work for.


Agree Unsure Disagree N/A
  1. My Supervisor motivates others to follow new processes
  1. My Supervisor establishes responsibility and accountability in their subordinates
  1. My supervisor is approachable and easy to talk with
  1. My Supervisor effectively resolves employee problems and labor issues
  1. My immediate supervisor sets a good example.


Agree Unsure Disagree N/A
  1. Communication is excellent in our department.
  1. Employees in the ____ department treat each other with respect.
  1. The department conducts a regular inventory of equipment.
  1. Our department generates required quarterly and annual reports on-time.
  1. Our department has reasonable goals that are achievable.

Information Technology/IT

Agree Unsure Disagree N/A
  1. Information Technology staff at this Company are easy to approach with a work related problem.
  1. The IT Department is quick to respond to my issues.
  1. If I have an IT problem, I know who to contact.
  1. Information Technology responds to my questions and inquiries in a timely manner.
  1. IT staff are knowledgeable about the software and equipment we use.


Agree Unsure Disagree N/A
  1. Our organization benchmarks progress against other organizations to see where we can improve
  1. My supervisor recognizes the benefits of diversity in the workplace
  1. Policies and procedures are regularly reviewed to examine their effects on employees in the workplace
  1. My manager recognizes the importance of inclusiveness in the workplace
  1. Employees have equal resources available to them to perform their jobs


Agree Unsure Disagree N/A
  1. Labor and Management work together to achieve the Company vision
  1. Goals and objectives are integrated and aligned with the Company vision
  1. Our Company is committed to providing competitive products and services
  1. The Company focus is clearly on customers and the development of innovative products
  1. Management is able to communicate a shared vision of the Company to all employees

General Open Ended Questions

  1. What are the top three challenges you face in your job?

  2. Would you refer others who are seeking employment to [Company]?

    If not, please explain:

  3. Are there any changes to an existing workflow, process or procedure you believe could improve your ability to perform your job more effectively or efficiently?

    If so, please describe:

  4. In your opinion, what are positive aspects of [Company]?

  5. What is the most important thing you would like to see [Company] do to improve as a place to work?

  6. On a scale of Excellent to Poor, how would you rate your overall employment experience
    with [Company] and why?

  7. Please enter any final comments you would like to share.


Questions below are optional, however, providing this information
will help us make accurate conclusions for specific work groups.
None of this information will be used to identify individual respondents.
  1. Your department:

  2. Years of Service:

  3. Your location:

  4. Your shift: