Team Leader Feedback Form
Staff Member
*
First Name
Last Name
Observer
*
First Name
Last Name
Date
*
/
Month
/
Day
Year
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Length of Obs
*
Hour Minutes
Pre observation information
First Observation info or update relevant action points from previous Observation
Task Observed
Planning and Preparation
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. resources and facilities selected, mental and physical preparation demonstrated, equipment prepared and ready for use)
Observing
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. task Observation)
Providing Feedback
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. Communication skills, written and verbal)
Walking the Floor
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. No predetermined outcomes or objectives)
Scanning the Environment
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. targeting specific areas or covering the whole operation)
Looking out for Potential Problems
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. lining of events that create failure)
Reporting and Compliance
Exceeded Expectation
Met Expectation
Below Expectation
Not Observed
Please give detailed information
(e.g. following company H&S policy and procedures, i.e. ANF, INF forms)
Feedback
(Within 24 hours)
Use of Questioning
(either for points not observed or to challenge understanding)
Areas of Particular Strength?
Areas for Future Development:
Observer Signature:
Team Leader Signature:
Date
*
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Month
/
Day
Year
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