Safety 360-Degree Assessment Survey Form
Participate in this comprehensive 360-degree assessment to help evaluate and improve our organization's safety practices and culture.
How would you rate the overall safety culture in your area?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about safety practices.
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Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Safety rules are clearly communicated
1
2
3
4
5
Management leads by example in safety matters
6
7
8
9
10
Co-workers support each other in following safety procedures
11
12
13
14
15
Safety training is frequent and effective
16
17
18
19
20
How confident are you in identifying and reporting unsafe conditions?
*
Not confident
1
2
3
4
Very confident
5
1 is Not confident, 5 is Very confident
How often do you observe the correct use of personal protective equipment (PPE)?
*
Always
Often
Sometimes
Rarely
Never
How effective is the incident reporting process in your area?
*
1
2
3
4
5
Please rate the frequency of safety training sessions you have attended in the past year.
*
Monthly or more
Quarterly
Twice a year
Once a year
Never
How well are near-miss incidents communicated to the team?
*
Not at all
1
2
3
4
Extremely well
5
1 is Not at all, 5 is Extremely well
How easy is it to access safety resources and materials when needed?
*
Very difficult
1
2
3
4
Very easy
5
1 is Very difficult, 5 is Very easy
How likely are you to recommend improvements to safety procedures?
*
Not likely
1
2
3
4
Extremely likely
5
1 is Not likely, 5 is Extremely likely
Additional comments or suggestions for improving safety (optional)
Submit Assessment
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